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General NPI Number Information
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NPI Number | 1043228471
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC IMAGING ASSOCIATES P C
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 935 VIRGINIA AVE NW
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City | NORTON
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State | VA
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Zip | 24273-1818
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Country | US
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Telephone | 276-679-2729
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Fax | 276-679-0578
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Provider Business Mailing Address
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Address Line | PO BOX 408
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City | NORTON
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State | VA
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Zip | 24273
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Country | US
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Telephone | 276-679-2729
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Fax | 276-679-0578
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Authorized Official
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Title or Position | PRESIDENT
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Name | KATHLEEN ANN DEPONTE
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Credential | MD
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Telephone | 276-679-2729
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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 | 28258
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35510
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25573
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35177
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License Number State | VA
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