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General NPI Number Information
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NPI Number | 1518752849
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Entity Type | Organization
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Legal Business Name | CARDIAC IMAGING INC
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 307 GRISHAM RD
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City | ROYAL
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State | AR
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Zip | 71968-9565
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Country | US
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Telephone | 501-276-6557
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 377
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City | ROYAL
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State | AR
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Zip | 71968-0377
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Country | US
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Telephone | 501-276-6557
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEVIN MCCLELLAN
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Credential | RVS RCS
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Telephone | 501-276-6557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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