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General NPI Number Information
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NPI Number | 1508956053
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Entity Type | Organization
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Legal Business Name | MEDICAL IMAGING ASSOCIATES PLLC
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 125 BUENA VISTA CIRCLE
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City | SOUTH HILL
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State | VA
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Zip | 23970
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Country | US
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Telephone | 757-620-9489
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Fax | 919-573-0486
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Provider Business Mailing Address
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Address Line | P. O . BOX 899 428 BRACEY LANE
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City | SOUTH HILL
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State | VA
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Zip | 23970
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Country | US
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Telephone | 434-447-4771
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Fax | 434-447-2204
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Authorized Official
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Title or Position | MANAGER
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Name | DR. WILLIAM BRYAN OLSON
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Credential | M.D.
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Telephone | 757-620-9489
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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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