Organization
PREMIER RADIOLOGY GROUP, INC.
Active
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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