Organization
ADVANCED RADIOLOGY OF GRAND ISLAND, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN L ALLEN MD (PRESIDENT/OWNER)
(308) 398-1344
Entity
Organization
Contact information
Practice address
730 N DIERS AVE, GRAND ISLAND, NE 68803-4954
(308) 398-1344
(308) 398-1346
Mailing address
730 N DIERS AVE, GRAND ISLAND, NE 68803-4954
(308) 398-1344
(308) 398-1346
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025333200
—
NE
01
—
DE0658
RAILROAD MEDICARE
NE
Enumeration date
06/18/2006
Last updated
10/11/2016
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