Organization
PORTAGE RADIOLOGY, SC
Active
Organization
PORTAGE RADIOLOGY, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG N MAGNES MD (OWNER)
(608) 742-4131
Entity
Organization
Contact information
Practice address
2817 NEW PINERY RD, PORTAGE, WI 53901-9257
(608) 742-4131
(608) 826-2710
Mailing address
2817 NEW PINERY RD, PORTAGE, WI 53901-9257
(608) 742-4131
(608) 826-2710
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21266400
—
WI
Enumeration date
08/04/2006
Last updated
05/09/2018
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