Healthcare Provider Details

I. General information

NPI: 1578835237
Provider Name (Legal Business Name): AMERICAN IMAGING AND MRI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2012
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2716 S WESTERN AVE
MARION IN
46953-3574
US

IV. Provider business mailing address

2716 S WESTERN AVE
MARION IN
46953-3574
US

V. Phone/Fax

Practice location:
  • Phone: 765-662-0100
  • Fax: 765-662-0101
Mailing address:
  • Phone: 765-662-0100
  • Fax: 765-662-0101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number01036335A
License Number StateIN

VIII. Authorized Official

Name: GARDNER BARTROM
Title or Position: PRESIDENT
Credential:
Phone: 765-662-0100