MEDICARE: HOBBIE RADIOLOGY

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	053927	CT
2	2085R0202X	Diagnostic Radiology Physician	MD20481	ME
3	2085R0202X	Diagnostic Radiology Physician	ME123941	FL
4	2085R0202X	Diagnostic Radiology Physician	202292	NY
5	2085R0202X	Diagnostic Radiology Physician	26357	WV
6	2085R0202X	Diagnostic Radiology Physician	MD058608L	PA

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	:	1528519949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOBBIE RADIOLOGY

Provider Business Mailing Address
First Line	:	101 GREENFIELD DR
Second Line	:
City	:	CLARKS SUMMIT
State	:	PA
Zip	:	18411-9152
Country	:	US
Telephone Number	:	570-290-0234
Fax Number	:	570-300-2790

Provider Business Practice Location Address
First Line	:	101 GREENFIELD DR
Second Line	:
City	:	CLARKS SUMMIT
State	:	PA
Zip	:	18411-9152
Country	:	US
Telephone Number	:	570-290-0234
Fax Number	:	570-586-8206

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. JULIANN HALL
Credential	:
Telephone Number	:	570-357-9864

Provider Enumeration Date	:	10/20/2016
Last Update Date	:	10/20/2016

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1851390140 — DR. JOSEPH PAUL VILOGI M.D.
Practice Location Address:

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Directions to “HOBBIE RADIOLOGY ” Practice Location

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