Healthcare Provider Details

I. General information

NPI: 1942253687
Provider Name (Legal Business Name): THE RADIOLOGY GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 11/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 PROVIDENCE DRIVE
NEWBERG OR
97132
US

IV. Provider business mailing address

PO BOX 25184
PORTLAND OR
97298-0184
US

V. Phone/Fax

Practice location:
  • Phone: 503-537-1780
  • Fax:
Mailing address:
  • Phone: 503-292-9108
  • Fax: 503-292-0346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES S PUTNAM
Title or Position: PRESIDENT
Credential: MD
Phone: 503-216-4830