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General NPI Number Information
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NPI Number | 1538405477
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Entity Type | Organization
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Legal Business Name | COLUMBUS DIAGNOSTIC IMAGING, LLC
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Dates
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Enumeration Date | 12/21/2012
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Last Update Date | 04/26/2019
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Provider Practice Location Address
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Address Line | 790 CREEKVIEW DR
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City | COLUMBUS
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State | IN
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Zip | 47201-2606
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Country | US
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Telephone | 812-376-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 790 CREEKVIEW DR
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City | COLUMBUS
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State | IN
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Zip | 47201-2606
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Country | US
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Telephone | 812-376-1000
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | RHONDA LENNON
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Credential |
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Telephone | 812-376-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #2
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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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