Healthcare Provider Details

I. General information

NPI: 1497733554
Provider Name (Legal Business Name): HIGH POINT RADIOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2006
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 EASTCHESTER DR SUITE 200
HIGH POINT NC
27265-3170
US

IV. Provider business mailing address

PO BOX 5007
HIGH POINT NC
27262-5007
US

V. Phone/Fax

Practice location:
  • Phone: 336-882-1416
  • Fax: 336-882-8264
Mailing address:
  • Phone: 336-882-1416
  • Fax: 336-882-8264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: NANCY J HOLLAND
Title or Position: PRACTICE ADMINISTRATOR
Credential: MBA,MHA
Phone: 336-882-1416