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General NPI Number Information
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NPI Number | 1386957942
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Entity Type | Organization
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Legal Business Name | LAKE CITY DIAGNOSTIC IMAGING, INC.
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Dates
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Enumeration Date | 07/23/2010
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 148 SAULS ST
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City | LAKE CITY
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State | SC
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Zip | 29560-2631
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Country | US
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Telephone | 843-374-0450
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Fax | 843-374-0451
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Provider Business Mailing Address
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Address Line | 23 MAIN ST SUITE 103
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City | HILTON HEAD
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State | SC
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Zip | 29926-6606
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Country | US
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Telephone | 843-342-2400
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Fax | 843-342-5898
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MURAT CAGLAYAN
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Credential |
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Telephone | 843-342-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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