MEDICARE: KENNEWICK RADIOLOGY GROUP 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

General Provider Information

NPI Number	:	1942431739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENNEWICK RADIOLOGY GROUP PC

Provider Business Mailing Address
First Line	:	PO BOX 1441
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79105-1441
Country	:	US
Telephone Number	:	509-586-5779
Fax Number	:	509-586-5178

Provider Business Practice Location Address
First Line	:	4045 E DESERT CREST DR
Second Line	:
City	:	PARADISE VALLEY
State	:	AZ
Zip	:	85253-3942
Country	:	US
Telephone Number	:	509-586-5779
Fax Number	:	509-586-5178

Authorized Official
Title or Position	:	PROVIDER/OWNER
Name	:	MR. RICHARD J RHEE
Credential	:
Telephone Number	:	800-941-4365

Provider Enumeration Date	:	07/28/2009
Last Update Date	:	09/23/2009

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Directions to “KENNEWICK RADIOLOGY GROUP PC ” Practice Location

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