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Broken Arrow Diagnostic Medicine, Pllc

Family Medicine Physician in Broken Arrow, OK · enumerated 2013 · authorized official Jacob Callison, Managing Member.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1710322672

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Registry record

Entity type Organization (Type 2)
Legal business name Broken Arrow Diagnostic Medicine, Pllc
Practice address 5050 E Kenosha St, Broken Arrow, OK, 74014
Phone (918) 994-5140
Fax (918) 994-5150
Enumeration date May 6, 2013
Last updated in NPPES Oct 8, 2024

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Jacob Callison
Title Managing Member
Phone (918) 994-5140

Other identifiers

Identifier Type State Issuer
200520620A Medicaid OK -
1700851052 Other OK NPI
1487885877 Other OK NPI

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Broken Arrow Diagnostic Medicine, Pllc?
The NPI for Broken Arrow Diagnostic Medicine, Pllc is 1710322672, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Broken Arrow Diagnostic Medicine, Pllc?
NPPES lists Jacob Callison (Managing Member) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-10-08.