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NPI Code Detail

MEDICARE: ASSOCIATES IN DIAGNOSTIC RADIOLOGY INC

MEDICARE: ASSOCIATES IN DIAGNOSTIC RADIOLOGY INC
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
12085R0202XDiagnostic Radiology PhysicianTN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
32006511OTHERTNBC/BS OF TN
4221822OTHERTNBLACK LUNG
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437119328
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASSOCIATES IN DIAGNOSTIC RADIOLOGY INC
Provider Business Mailing Address
First Line : PO BOX 3145
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46206-3145
Country : US
Telephone Number : 855-206-8406
Fax Number : 855-823-8132
Provider Business Practice Location Address
First Line : 2333 MCCALLIE AVE
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37404-3258
Country : US
Telephone Number : 423-493-1387
Fax Number : 423-553-1224
Authorized Official
Title or Position : COO
Name : SUE KILPATRICK
Credential :
Telephone Number : 423-553-1220
Provider Enumeration Date : 03/24/2006
Last Update Date : 07/21/2022

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1245206978 — GARY R LANHAM MD
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1417923228 — SOUTHERN PATHOLOGY ASSOCIATES INC
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1306806690 — JENNIFER LEANN MOSER
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Directions to “ASSOCIATES IN DIAGNOSTIC RADIOLOGY INC ” Practice Location

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