MEDICARE: ADVANCED IMAGING ASSOCIATES PSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DA2906	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000244294	OTHER	KY	BC/BS GROUP PIN NUMBER

General Provider Information

NPI Number	:	1023016532
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED IMAGING ASSOCIATES PSC

Provider Business Mailing Address
First Line	:	PO BOX 633638
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-3638
Country	:	US
Telephone Number	:	866-287-0542
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 JAMES TRIMBLE BLVD
Second Line	:
City	:	PAINTSVILLE
State	:	KY
Zip	:	41240-1055
Country	:	US
Telephone Number	:	606-789-3511
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALLLEN BOND
Credential	:	MD
Telephone Number	:	606-789-3511

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	03/15/2012

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Directions to “ADVANCED IMAGING ASSOCIATES PSC ” Practice Location

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