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General NPI Number Information
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NPI Number | 1013523687
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Entity Type | Organization
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Legal Business Name | IV MEDICAL DIAGNOSTICS, PC
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Dates
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Enumeration Date | 09/19/2020
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 361 VISTA DR
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-1054
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Country | US
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Telephone | 917-310-5925
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Fax |
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Provider Business Mailing Address
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Address Line | 20 RUSTIC RIDGE RD
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City | FREDERICKSBURG
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State | VA
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Zip | 22405-6033
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Country | US
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Telephone | 540-656-6464
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. KYON A. HOOD
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Credential | MD
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Telephone | 540-656-6464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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