Healthcare Provider Details

I. General information

NPI: 1457339277
Provider Name (Legal Business Name): RADIOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3448 US ROUTE 60
HUNTINGTON WV
25705-2906
US

IV. Provider business mailing address

PO BOX 910
HUNTINGTON WV
25712-0910
US

V. Phone/Fax

Practice location:
  • Phone: 304-522-1550
  • Fax: 304-522-0704
Mailing address:
  • Phone: 304-522-1550
  • Fax: 304-522-0704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. BILL WRIGHT
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 304-522-1550