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Organization

PREMIER RADIOLOGY GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBIN E OSBORN DO (COO)
(937) 398-0500
Entity
Organization

Contact information

Practice address
2145 N. FAIRFIELD RD., SUITE A, BEAVERCREEK, OH 45431
(937) 431-9729
(937) 431-9731
Mailing address
2145 N. FAIRFIELD RD., SUITE A, BEAVERCREEK, OH 45431
(937) 431-9729
(937) 431-9731

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0610IC
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16-01294
UHC GROUP NUMBER
OH
01
206519
ANTHEM GROUP NUMBER
OH
05
2133882
OH
01
4500901
AETNA GROUP NUMBER
OH
01
6393474001
CIGNA GROUP NUMBER
OH
01
IC133
HUMANA GROUP NUMBER
OH
Enumeration date
10/02/2006
Last updated
08/22/2020
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