Organization
STADIUM OPEN MRI, LLC
Active
Other names
ProScan Imaging Paycor Stadium
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL ALEXANDER BARBER (DIRECTOR, RCM)
(513) 316-9385
Entity
Organization
Contact information
Practice address
6 PAYCOR STADIUM, CINCINNATI, OH 45202-3418
(513) 455-4999
(513) 455-4998
Mailing address
6 PAYCOR STADIUM, CINCINNATI, OH 45202-3418
(513) 455-4999
(513) 455-4998
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0677IC
OH
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000332753
ANTHEM PIN
OH
05
—
200473300A
—
IN
05
—
2228888
—
OH
05
—
86000585
—
KY
Enumeration date
10/28/2005
Last updated
05/30/2024
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