Organization
ADVANCED DIAGNOSTIC IMAGING PC
Active
Other names
Advanced Diagnostic Imaging West
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA L. FORD (GENERAL MANAGER)
(812) 471-7086
Entity
Organization
Contact information
Practice address
319 N SAINT JOSEPH AVE, EVANSVILLE, IN 47712-5562
(812) 423-9702
Mailing address
1120 PROFESSIONAL BLVD, EVANSVILLE, IN 47714-8000
(812) 471-7086
(812) 471-3381
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200181650A
—
IN
Enumeration date
02/06/2007
Last updated
06/18/2008
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