Organization
RUSSELLVILLE DIAGNOSTIC IMAGING
Active
Organization
RUSSELLVILLE DIAGNOSTIC IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD M TALMADGE MD (DIRECTOR)
(270) 725-4561
Entity
Organization
Contact information
Practice address
1625 NASHVILLE ST, RUSSELLVILLE, KY 42276-8853
(270) 725-4561
Mailing address
PO BOX 3339, CLARKSVILLE, TN 37043-3339
(931) 647-5034
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD36221
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000566896
ANTHEM BCBS
KY
05
—
7100040150
—
KY
01
—
DN6583
RAILROAD MEDICARE
—
Enumeration date
03/19/2008
Last updated
11/17/2008
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