Organization
IMAGING GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY WALKER (BOARD OF DIRECTORS)
(303) 914-8800
Entity
Organization
Contact information
Practice address
938 BANNOCK ST, STE 300, DENVER, CO 80204-4028
(303) 914-8800
Mailing address
938 BANNOCK ST, STE 300, DENVER, CO 80204-4028
(303) 914-8800
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46631542
—
CO
01
—
P00217267
RAILROAD MEDICARE
CO
Enumeration date
02/21/2007
Last updated
10/02/2007
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