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General NPI Number Information
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NPI Number | 1013973940
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Entity Type | Organization
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Legal Business Name | VIRTUAL RADIOLOGY ASSOCIATES, PLL
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 03/30/2011
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Provider Practice Location Address
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Address Line | 2001 S MAIN ST
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City | HOPE
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State | AR
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Zip | 71801-8124
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Country | US
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Telephone | 870-845-5718
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Fax | 870-845-3554
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Provider Business Mailing Address
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Address Line | PO BOX 611
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City | NASHVILLE
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State | AR
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Zip | 71852-0611
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Country | US
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Telephone | 870-845-5718
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Fax | 870-845-3554
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Authorized Official
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Title or Position | OWNER
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Name | LAWRENCE R BIGONGIARI
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Credential | M.D.
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Telephone | 870-845-5718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MC2394
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License Number State | AR
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