Organization
SPECTRUM RADIOLOGY ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROL A JACKSON-GIBSON MD (PRESIDENT)
(716) 688-7622
Entity
Organization
Contact information
Practice address
1150 YOUNGS RD, SUITE 111, WILLIAMSVILLE, NY 14221-8053
(716) 688-7622
(716) 688-7592
Mailing address
1150 YOUNGS RD, SUITE 111, WILLIAMSVILLE, NY 14221-8053
(716) 688-7622
(716) 688-7592
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02143864
—
NY
01
—
512627001
BLUE CROOS WNY GROUP NO.
NY
Enumeration date
09/16/2006
Last updated
04/26/2013
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