Healthcare Provider Details

I. General information

NPI: 1093956583
Provider Name (Legal Business Name): IMAGING ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2009
Last Update Date: 12/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 COUNTY ROAD 710
JONESBORO AR
72401-8327
US

IV. Provider business mailing address

PO BOX 110359
NASHVILLE TN
37222-0359
US

V. Phone/Fax

Practice location:
  • Phone: 615-724-2356
  • Fax:
Mailing address:
  • Phone: 615-724-2356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number StateAR

VIII. Authorized Official

Name: JOE HART
Title or Position: BILLING MANAGER
Credential:
Phone: 615-724-2356