Healthcare Provider Details

I. General information

NPI: 1013960053
Provider Name (Legal Business Name): MEDICAL WEST IMAGING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 MEMORIAL DR
BESSEMER AL
35022-6029
US

IV. Provider business mailing address

995 9TH AVE SW
BESSEMER AL
35022-4527
US

V. Phone/Fax

Practice location:
  • Phone: 205-428-9120
  • Fax: 205-428-9248
Mailing address:
  • Phone: 205-481-7670
  • Fax: 205-481-7397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. LEE MORRISON
Title or Position: ADMINISTRATOR
Credential:
Phone: 205-428-9120