Healthcare Provider Details

I. General information

NPI: 1699072611
Provider Name (Legal Business Name): IMAGING ASSOCIATES OF INDIANA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2011
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W 86TH ST
INDIANAPOLIS IN
46260-1902
US

IV. Provider business mailing address

PO BOX 208807
DALLAS TX
75320-8807
US

V. Phone/Fax

Practice location:
  • Phone: 219-767-6320
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberNONE
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberNONE
License Number StateIN

VIII. Authorized Official

Name: KAREN VAUGHN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 629-317-1465