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General NPI Number Information
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NPI Number | 1104167469
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Entity Type | Organization
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Legal Business Name | BEND MRI LLC
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Dates
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Enumeration Date | 03/12/2013
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Last Update Date | 03/12/2013
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Provider Practice Location Address
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Address Line | 2421 NE DOCTORS DR
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City | BEND
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State | OR
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Zip | 97701-6031
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Country | US
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Telephone | 541-388-3311
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Fax | 541-389-1887
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Provider Business Mailing Address
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Address Line | 2421 NE DOCTORS DR
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City | BEND
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State | OR
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Zip | 97701-6031
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Country | US
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Telephone | 541-388-3311
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Fax | 541-389-1887
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHEN PAUL IRELAND
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Credential | MD
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Telephone | 541-388-3311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471M1202X
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Taxonomy Name | Magnetic Resonance Imaging Radiologic Technologist
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License Number |
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License Number State |
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