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General NPI Number Information
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NPI Number | 1538520721
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Entity Type | Organization
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Legal Business Name | BROOKWOOD DIAGNOSTIC IMAGING CENTER, LLC
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Dates
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Enumeration Date | 03/15/2016
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 513 BROOKWOOD BLVD SUITE 100
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6878
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Country | US
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Telephone | 469-893-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 513 BROOKWOOD BLVD SUITE 100
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6878
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Country | US
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Telephone | 469-893-2000
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Fax |
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Authorized Official
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Title or Position | OFFICER/AUTHORIZED OFFICIAL
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Name | JAIKUMAR KRISHNASWAMY
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Credential |
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Telephone | 972-713-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | I3772
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License Number State | AL
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