Healthcare Provider Details

I. General information

NPI: 1508093477
Provider Name (Legal Business Name): INTEGRATIVE IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2009
Last Update Date: 06/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 WILLOW CREEK DR SUITE 200
SPRINGDALE AR
72762-8704
US

IV. Provider business mailing address

5501 WILLOW CREEK DR SUITE 200
SPRINGDALE AR
72762-8704
US

V. Phone/Fax

Practice location:
  • Phone: 479-442-4553
  • Fax: 479-251-1006
Mailing address:
  • Phone: 479-442-4553
  • Fax: 479-251-1006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID HARSHFIELD
Title or Position: PHYSICIAN/PRINCIAL MANAGER
Credential: M.D.
Phone: 479-442-4553