Healthcare Provider Details

I. General information

NPI: 1598712085
Provider Name (Legal Business Name): DIAGNOSTIC IMAGING CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 DESALES AVE
CHATTANOOGA TN
37404-1161
US

IV. Provider business mailing address

PO BOX 879
DUNLAP TN
37327-0879
US

V. Phone/Fax

Practice location:
  • Phone: 423-495-4430
  • Fax: 423-495-6179
Mailing address:
  • Phone: 866-730-5619
  • Fax: 423-698-3622

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. JENNY M KRETZMEIER
Title or Position: ADMINISTRATOR
Credential:
Phone: 423-629-9783