Healthcare Provider Details

I. General information

NPI: 1336137090
Provider Name (Legal Business Name): PARLEE & TATEM RADIOLOGIC ASSOCIATES, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 W STATE ST
DOYLESTOWN PA
18901-2554
US

IV. Provider business mailing address

PO BOX 830624
PHILADELPHIA PA
19182-0624
US

V. Phone/Fax

Practice location:
  • Phone: 610-372-4957
  • Fax: 610-372-3735
Mailing address:
  • Phone: 800-666-1816
  • Fax: 706-653-0615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0009249600014
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: DR. CRAIG KESACK
Title or Position: PRESIDENT
Credential: MD
Phone: 215-345-2290