Healthcare Provider Details

I. General information

NPI: 1861446973
Provider Name (Legal Business Name): RUTHERFORD RADIOLOGICAL ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 08/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

288 S RIDGECREST AVE RUTHERFORD HOSPITAL INC
RUTHERFORDTON NC
28139
US

IV. Provider business mailing address

PO BOX 886
RUTHERFORDTON NC
28139
US

V. Phone/Fax

Practice location:
  • Phone: 828-286-5000
  • Fax:
Mailing address:
  • Phone: 828-287-2984
  • Fax: 828-287-3582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRIS B PARK
Title or Position: BUSINESS MANAGER
Credential:
Phone: 828-287-2984