Healthcare Provider Details

I. General information

NPI: 1053837609
Provider Name (Legal Business Name): ASSOCIATION OF UNIVERSITY RADIOLOGISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2017
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 W MAIN ST
BELGRADE MT
59714-3700
US

IV. Provider business mailing address

2240 SUTHERLAND AVE STE 107
KNOXVILLE TN
37919-2333
US

V. Phone/Fax

Practice location:
  • Phone: 865-584-7376
  • Fax:
Mailing address:
  • Phone: 865-584-7373
  • Fax: 865-540-3856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MICHAEL LANGENBERG
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 865-584-7376