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General NPI Number Information
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NPI Number | 1073666236
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Entity Type | Organization
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Legal Business Name | NATIONAL IMAGING, LTD
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 10/12/2012
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Provider Practice Location Address
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Address Line | 4713 N PORTWEST CIR
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City | WICHITA
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State | KS
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Zip | 67204-2356
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Country | US
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Telephone | 316-729-5517
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Fax | 316-729-5655
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Provider Business Mailing Address
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Address Line | 4713 N PORTWEST CIR
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City | WICHITA
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State | KS
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Zip | 67204-2356
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Country | US
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Telephone | 316-729-5517
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Fax | 316-729-5655
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Authorized Official
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Title or Position | OWNER
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Name | PAUL L RODRIGUEZ
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Credential | M.D.
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Telephone | 316-729-5517
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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 | 04-14664
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License Number State | KS
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