Organization
CLINICAL RADIOLOGISTS, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN WATSON MD (AUTHORIZED OFFICIAL)
(217) 789-7743
Entity
Organization
Contact information
Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3245
Mailing address
2040 W ILES AVE, SUITE C, SPRINGFIELD, IL 62704-4662
(217) 789-7743
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG2701
RAILROAD MEDICAR
IL
Enumeration date
05/31/2006
Last updated
04/08/2021
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