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General NPI Number Information
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NPI Number | 1861273815
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Entity Type | Organization
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Legal Business Name | PROSCAN IMAGING OF JEFFERSONVILLE, LLC
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Dates
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Enumeration Date | 10/06/2023
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 2027 JEFFERSONVILLE COMMONS DR
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-8996
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Country | US
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Telephone | 513-924-5489
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Fax |
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Provider Business Mailing Address
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Address Line | 5400 KENNEDY AVE STE 1
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City | CINCINNATI
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State | OH
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Zip | 45213-2668
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, REVENUE CYCLE
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Name | MR. DANIEL BARBER
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Credential |
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Telephone | 513-316-9385
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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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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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