Organization
MED IMAGING OF INDIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD SMITH (PRESIDENT)
(501) 786-0522
Entity
Organization
Contact information
Practice address
2045 RAMA DR, INDIANAPOLIS, IN 46219-1710
(317) 871-2790
(317) 871-2792
Mailing address
6948 ALCOA RD, SUITE K, BENTON, AR 72015-9726
(501) 778-9729
(501) 776-2695
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200908550A
—
IN
Enumeration date
11/14/2007
Last updated
01/22/2009
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