MEDICARE: ASSOCIATION OF UNIVERSITY RADIOLOGISTS, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407373053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATION OF UNIVERSITY RADIOLOGISTS, PC

Provider Business Mailing Address
First Line	:	2240 SUTHERLAND AVE STE 107
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-2333
Country	:	US
Telephone Number	:	865-584-7376
Fax Number	:	865-540-3856

Provider Business Practice Location Address
First Line	:	5779 CREEKWOOD PARK BLVD STE 130
Second Line	:
City	:	LENOIR CITY
State	:	TN
Zip	:	37772-1203
Country	:	US
Telephone Number	:	865-635-2800
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MICHAEL LANGENBERG
Credential	:
Telephone Number	:	865-584-7376

Provider Enumeration Date	:	08/24/2017
Last Update Date	:	08/24/2017

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