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NPI Code Detail

MEDICARE: ASSOCIATION OF UNIVERSITY RADIOLOGISTS, PC

MEDICARE: ASSOCIATION OF UNIVERSITY RADIOLOGISTS, 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
12085R0204XVascular & Interventional Radiology Physician
22085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1326564972
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASSOCIATION OF UNIVERSITY RADIOLOGISTS, PC
Provider Business Mailing Address
First Line : 2240 SUTHERLAND AVE STE 107
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-2333
Country : US
Telephone Number : 863-584-7376
Fax Number : 865-540-3856
Provider Business Practice Location Address
First Line : 101 PROFESSIONAL PARK PVT DR
Second Line :
City : COLONIAL HEIGHTS
State : TN
Zip : 37663-2288
Country : US
Telephone Number : 423-239-7300
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MICHAEL LANGENBERG
Credential :
Telephone Number : 865-584-7376
Provider Enumeration Date : 08/16/2017
Last Update Date : 11/08/2017

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