Broken Arrow Diagnostic Medicine, PLLC
NPI 1710322672ActiveOrganization· Family Medicine· Broken Arrow, OK
Family Medicine in Broken Arrow, Oklahoma, registered in NPPES in May 2013. The authorized official on file is Jacob Leon Callison, PA, Managing Member. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1710322672 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 6, 2013 |
| Last updated in NPPES | Oct 8, 2024 |
| Certified by provider | Oct 8, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | OK |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (OK) |
|---|
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