Healthcare Provider Details

I. General information

NPI: 1699733162
Provider Name (Legal Business Name): RADIOLOGY AND NUCLEAR MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SW 10TH AVE
TOPEKA KS
66604-1301
US

IV. Provider business mailing address

PO BOX 219995
KANSAS CITY MO
64121-9995
US

V. Phone/Fax

Practice location:
  • Phone: 785-354-6000
  • Fax: 706-653-8732
Mailing address:
  • Phone: 785-234-2306
  • Fax: 785-234-2895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number04-33832
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number StateKS
# 6
Primary TaxonomyN
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TIMOTHY E ALLEN
Title or Position: CHAIRMAN
Credential: MD
Phone: 785-234-2306