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Organization
SJRMC INTERVENTIONAL RADIOLOGY SERVICES LLC
Active
Organization
SJRMC INTERVENTIONAL RADIOLOGY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRANCE DILLON (ASST SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 750-7445
(208) 750-7395
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7000
(615) 920-8775
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085N0700X
Neuroradiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Enumeration date
08/12/2013
Last updated
03/24/2022
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