MEDICARE: DIAGNOSTIC 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	2085R0202X	Diagnostic Radiology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CN2807	OTHER		RAILROAD WORKERS 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

General Provider Information

NPI Number	:	1518947399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIAGNOSTIC RADIOLOGY ASSOCIATES PC

Provider Business Mailing Address
First Line	:	PO BOX 308
Second Line	:
City	:	MONTROSE
State	:	CO
Zip	:	81402-0308
Country	:	US
Telephone Number	:	970-765-0818
Fax Number	:	970-497-8410

Provider Business Practice Location Address
First Line	:	2351 G RD
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-9641
Country	:	US
Telephone Number	:	970-644-4345
Fax Number	:	970-644-4379

Authorized Official
Title or Position	:	MANAGING OFFICIAL
Name	:	TODD E. HEGSTROM
Credential	:	MD
Telephone Number	:	970-644-4345

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	09/01/2020

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