Healthcare Provider Details

I. General information

NPI: 1386081248
Provider Name (Legal Business Name): ALL-AMERICAN TELERADIOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2013
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27101 E OVIATT RD STE 3
BAY VILLAGE OH
44140-3301
US

IV. Provider business mailing address

27005 KNICKERBOCKER RD
BAY VILLAGE OH
44140-2383
US

V. Phone/Fax

Practice location:
  • Phone: 888-365-5514
  • Fax: 800-616-0084
Mailing address:
  • Phone: 888-365-5514
  • Fax: 800-616-0084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRYSTY RADABAUGH
Title or Position: VP OF OPERATIONS
Credential:
Phone: 888-365-5514