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General NPI Number Information
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NPI Number | 1396781365
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL RAADIOLOGY INC
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 03/10/2008
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Provider Practice Location Address
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Address Line | 3125 HAMILTON MASON RD
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City | HAMILTON
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State | OH
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Zip | 45011-5307
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Country | US
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Telephone | 513-872-4500
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Fax | 513-872-4518
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Provider Business Mailing Address
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Address Line | 4170 ROSSLYN DR SUITE B
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City | CINCINNATI
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State | OH
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Zip | 45209-1197
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Country | US
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Telephone | 513-872-4500
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Fax | 513-872-4518
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MR. JOSEPH R HUDEPOHL
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Credential |
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Telephone | 513-527-0401
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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 | 316204
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License Number State | OH
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