MEDICARE: RADIOLOGY ASSOCIATES, PC

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	174400000X	Specialist

General Provider Information

NPI Number	:	1093833717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIOLOGY ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	PO BOX 53
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97440-0053
Country	:	US
Telephone Number	:	541-687-7134
Fax Number	:	541-687-7135

Provider Business Practice Location Address
First Line	:	2699 N 17TH ST
Second Line	:
City	:	COOS BAY
State	:	OR
Zip	:	97420-2111
Country	:	US
Telephone Number	:	541-687-7134
Fax Number	:	541-687-7135

Authorized Official
Title or Position	:	ADMIN
Name	:	BURT LOESSBERG
Credential	:
Telephone Number	:	541-687-7134

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	08/22/2020

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