MEDICARE: FORT PAYNE MRI LLC

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
2	261QR0200X	Radiology Clinic/Center

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	:	1730145988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORT PAYNE MRI LLC

Provider Business Mailing Address
First Line	:	1110 GLENN BLVD SW
Second Line	:	SUITE 100
City	:	FORT PAYNE
State	:	AL
Zip	:	35967-8486
Country	:	US
Telephone Number	:	256-845-9402
Fax Number	:	256-845-9410

Provider Business Practice Location Address
First Line	:	1110 GLENN BLVD SW
Second Line	:	SUITE 100
City	:	FORT PAYNE
State	:	AL
Zip	:	35967-8486
Country	:	US
Telephone Number	:	256-845-9402
Fax Number	:	256-845-9410

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	JAMES W. HOLMES
Credential	:
Telephone Number	:	337-291-9161

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	03/04/2026

Similar Medicare Providers

1538925615 — FTP MRI RADIOLOGY, PLLC
Practice Location Address:

1110 GLENN BLVD SW STE B
FORT PAYNE, AL
35967-8486

Practice Phone: 256-845-9402
Practice Fax: 256-845-9410

1437005295 — SELENA STEWART LMSW
Practice Location Address:

1951 GAULT AVE N
FORT PAYNE, AL
35967-3417

Practice Phone: 256-273-6800
Practice Fax:

1457423428 — DR. J ARLENE MCFARLAND DNS, LMFT
Practice Location Address:

216 GAULT AVE N
FORT PAYNE, AL
35967-2104

Practice Phone: 256-845-7920
Practice Fax: 256-845-7820

1417951112 — MR. BARTON DRAKE IBSEN P.T.
Practice Location Address:

121 DRINKARD DR
FORT PAYNE, AL
35967

Practice Phone: 256-997-9006
Practice Fax: 256-997-0606

1033103817 — C & H DISCOUNT DRUGS INC
Practice Location Address:

1916 GAULT AVE N
FORT PAYNE, AL
35967-3418

Practice Phone: 256-845-2004
Practice Fax: 256-845-7839

1114913373 — DR. BART ONIS BARBER DO
Practice Location Address:

1600 GAULT AVE S
FORT PAYNE, AL
35967-4741

Practice Phone: 256-979-1972
Practice Fax: 256-979-1974

Directions to “FORT PAYNE MRI LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.