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NPI Code Detail

MEDICARE: MEMPHIS RADIOLOGICAL, P.C.

MEDICARE: MEMPHIS RADIOLOGICAL, P.C.
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
12085R0202XDiagnostic Radiology PhysicianTN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CC0445OTHERTNRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639172851
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEMPHIS RADIOLOGICAL, P.C.
Provider Business Mailing Address
First Line : DEPT 24 PO BOX 1000
Second Line :
City : MEMPHIS
State : TN
Zip : 38148
Country : US
Telephone Number : 901-685-2696
Fax Number : 423-826-1290
Provider Business Practice Location Address
First Line : 1265 UNION AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-3415
Country : US
Telephone Number : 901-685-2696
Fax Number : 423-826-1290
Authorized Official
Title or Position : PRESIDENT
Name : DR. DALE E HANSEN JR.
Credential : MD
Telephone Number : 901-685-2696
Provider Enumeration Date : 05/23/2005
Last Update Date : 07/21/2022

Similar Medicare Providers

1225334469 — DR. ELIZABETH MCCONNELL BAKER DNP, ACNP-BC
Practice Location Address:
1265 UNION AVE
MEMPHIS, TN
38104-3415
Practice Phone: 901-516-2875
Practice Fax: 901-516-8254
1245664416 — FARHAN AHMAD KHAN MD
Practice Location Address:
1265 UNION AVE
MEMPHIS, TN
38104-3415
Practice Phone: 901-516-7182
Practice Fax: 901-276-5474
1235586439 — MICHAEL KOPINSKI CRNA
Practice Location Address:
1265 UNION AVE
MEMPHIS, TN
38104-3415
Practice Phone: 901-725-5846
Practice Fax:
1306886825 — KENNETH I ATAGA MD
Practice Location Address:
1265 UNION AVE
MEMPHIS, TN
38104-3415
Practice Phone: 901-478-2760
Practice Fax: 901-478-8358
1982662961 — DR. MICHAEL S GELFAND MD
Practice Location Address:
1265 UNION AVE
MEMPHIS, TN
38104-3415
Practice Phone: 901-758-7888
Practice Fax: 901-387-5153
1467423475 — ROBERT MORRIS KENT MD
Practice Location Address:
1265 UNION AVE
MEMPHIS, TN
38104-3415
Practice Phone: 901-725-5846
Practice Fax:
1154990661 — JOSHUA AKINSANYA
Practice Location Address:
1265 UNION AVE
MEMPHIS, TN
38104-3415
Practice Phone: 901-516-2362
Practice Fax: 901-516-8254

Directions to “MEMPHIS RADIOLOGICAL, P.C. ” Practice Location

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