Healthcare Provider Details
I. General information
NPI: 1033365374
Provider Name (Legal Business Name): CLARION DIAGNOSTIC IMAGING, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/18/2008
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 HOSPITAL DR
CLARION PA
16214-8501
US
IV. Provider business mailing address
PO BOX 486
CLARION PA
16214-0486
US
V. Phone/Fax
- Phone: 814-226-9500
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MRS.
SHARON
D
SPENCE
Title or Position: BILLING ADMINISTATOR
Credential:
Phone: 814-864-9932