Healthcare Provider Details

I. General information

NPI: 1417993221
Provider Name (Legal Business Name): BOZEMAN MEDICAL IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 ANALYSIS DR ADVANCED TECHNOLOGY PARK
BOZEMAN MT
59718-6814
US

IV. Provider business mailing address

2150 ANALYSIS DR ADVANCED TECHNOLOGY PARK
BOZEMAN MT
59718-6814
US

V. Phone/Fax

Practice location:
  • Phone: 406-582-0005
  • Fax: 406-582-0830
Mailing address:
  • Phone: 406-582-0005
  • Fax: 406-582-0830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number06-00002458
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number06-00002458
License Number StateMT

VIII. Authorized Official

Name: MR. TIMOTHY L NAGEL
Title or Position: DIRECTOR/MANAGING PARTNER
Credential: M.S.
Phone: 406-582-0005