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General NPI Number Information
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NPI Number | 1326964107
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Entity Type | Organization
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Legal Business Name | GREEN AND GOLD IMAGING LLC
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Dates
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Enumeration Date | 06/26/2026
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Last Update Date | 06/26/2026
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Provider Practice Location Address
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Address Line | 3318 N UNIVERSITY DR
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City | NACOGDOCHES
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State | TX
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Zip | 75965
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Country | US
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Telephone | 936-888-3318
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Fax | 936-888-3319
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Provider Business Mailing Address
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Address Line | PO BOX 106256 LOCKBOX 596256
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City | ATLANTA
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State | GA
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Zip | 30348-6256
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Country | US
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Telephone | 479-452-9416
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Fax | 479-242-1990
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Authorized Official
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Title or Position | CO-OWNER
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Name | NEAL KLITSCH
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Credential | MD
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Telephone | 412-983-6572
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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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