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General NPI Number Information
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NPI Number | 1285692848
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Entity Type | Organization
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Legal Business Name | COLORADO RIVER RADIOLOGY PC
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 2735 SILVER CREEK RD
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442
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Country | US
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Telephone | 928-763-2273
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Fax | 928-704-6781
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Provider Business Mailing Address
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Address Line | PO BOX 1888
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City | GREENVILLE
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State | TX
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Zip | 75403
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Country | US
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Telephone | 800-945-2455
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Fax | 903-453-2541
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES R LASH
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Credential | DO
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Telephone | 928-763-2273
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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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