Organization
NORTHWEST RADIOLOGY ASSOCIATES P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY HICKEY M.D. (PRESIDENT)
(802) 524-1058
Entity
Organization
Contact information
Practice address
133 FAIRFIELD ST, SAINT ALBANS, VT 05478-1726
(802) 524-1058
(802) 524-7021
Mailing address
PO BOX 1359, WILLISTON, VT 05495-1359
(802) 524-7100
(802) 524-7021
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008129
—
VT
01
—
58514
BLUE CROSS GROUP NUMBER
VT
Enumeration date
12/18/2006
Last updated
01/04/2008
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