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General NPI Number Information
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NPI Number | 1124471149
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Entity Type | Organization
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Legal Business Name | PROSCAN RADIOLOGY ARKANSAS, LLC
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 07/14/2016
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Provider Practice Location Address
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Address Line | 2929 LAKEWOOD VILLAGE DR
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-8033
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Country | US
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Telephone | 513-924-2115
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Fax |
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Provider Business Mailing Address
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Address Line | 2929 LAKEWOOD VILLAGE DR
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-8033
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SENIOR DIRECTOR, CORPORATE ADMIN.
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Name | KAREN E AMAYA
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Credential |
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Telephone | 513-924-5174
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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 |
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License Number State |
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