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General NPI Number Information
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NPI Number | 1891782983
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Entity Type | Organization
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Legal Business Name | EVANSVILLE RADIOLOGY PC
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 07/09/2024
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Provider Practice Location Address
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Address Line | 350 W COLUMBIA ST SUITE 420
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City | EVANSVILLE
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State | IN
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Zip | 47710-1782
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Country | US
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Telephone | 812-422-3254
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Fax | 812-426-6388
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Provider Business Mailing Address
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Address Line | 350 W COLUMBIA ST SUITE 420
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City | EVANSVILLE
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State | IN
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Zip | 47710-1782
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Country | US
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Telephone | 812-422-3254
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Fax | 812-426-6388
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEE HOAGLAND
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Credential | MD
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Telephone | 812-422-3254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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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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