Healthcare Provider Details

I. General information

NPI: 1396780433
Provider Name (Legal Business Name): HUDDLE RADIOLOGY & IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 10/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 W MARION RD
MOUNT GILEAD OH
43338-1027
US

IV. Provider business mailing address

PO BOX 769 1109 EASTERN AVE
ASHLAND OH
44805-0769
US

V. Phone/Fax

Practice location:
  • Phone: 419-281-4020
  • Fax: 419-281-8767
Mailing address:
  • Phone: 419-281-4959
  • Fax: 419-281-8767

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: MRS. JANET M STUART
Title or Position: MGR
Credential:
Phone: 419-281-4959