Healthcare Provider Details

I. General information

NPI: 1588638241
Provider Name (Legal Business Name): WAYNE MRI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 WAYNE MEMORIAL DR
GOLDSBORO NC
27534-9494
US

IV. Provider business mailing address

2700 WAYNE MEMORIAL DR
GOLDSBORO NC
27534-9494
US

V. Phone/Fax

Practice location:
  • Phone: 919-731-6142
  • Fax: 919-731-6966
Mailing address:
  • Phone: 919-731-6142
  • Fax: 919-731-6966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number StateNC

VIII. Authorized Official

Name: MR. J WILLIAM PAUGH
Title or Position: MANAGER
Credential:
Phone: 919-731-6142