Healthcare Provider Details
I. General information
NPI: 1437120599
Provider Name (Legal Business Name): UNIVERSITY RADIOLOGY ASSOCIATES OF CINCINNATI, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/27/2006
Last Update Date: 03/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
234 GOODMAN ST
CINCINNATI OH
45267-1000
US
IV. Provider business mailing address
2830 VICTORY PKWY
CINCINNATI OH
45206-1785
US
V. Phone/Fax
- Phone: 513-584-4391
- Fax: 513-584-0431
- Phone: 513-245-3617
- Fax: 513-475-7259
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | 35-043613 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207U00000X |
| Taxonomy | Nuclear Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207UN0903X |
| Taxonomy | In Vivo & In Vitro Nuclear Medicine Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LISA
HUNT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 513-245-3663