Organization
DIAGNOSTIC IMAGING ASSOCIATES P C
Active
Other names
Radiologist
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN ANN DEPONTE MD (PRESIDENT)
(276) 679-2729
Entity
Organization
Contact information
Practice address
935 VIRGINIA AVE NW, NORTON, VA 24273-1818
(276) 679-2729
(276) 679-0578
Mailing address
PO BOX 408, NORTON, VA 24273
(276) 679-2729
(276) 679-0578
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25573
NC
2085R0202X
Diagnostic Radiology Physician
28258
KY
2085R0202X
Diagnostic Radiology Physician
Primary
35177
VA
2085R0202X
Diagnostic Radiology Physician
35510
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007200781
—
VA
01
—
026544500
DEPT OF LABOR
—
01
—
099837
ANTHEM BLUE CROSS
—
01
—
1397456
UMWA
—
01
—
300009291
RAILROAD MEDICARE
—
05
—
4404574
—
TN
01
—
64794456
KY MED
KY
Enumeration date
08/03/2006
Last updated
07/13/2015
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