Healthcare Provider Details
I. General information
NPI: 1548341357
Provider Name (Legal Business Name): RADIOLOGY ASSSOCIATES OF CANTON, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2006
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2600 6TH ST SW
CANTON OH
44710-1702
US
IV. Provider business mailing address
PO BOX 72384
CLEVELAND OH
44192-0002
US
V. Phone/Fax
- Phone: 234-260-6974
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAREN
MARIE
VAUGHN
Title or Position: AO
Credential:
Phone: 629-317-1465