Organization
INDIANA UNIVERSITY RADIOLOGY ASSOCIATES INC
Active
Parent organization
IU RADIOLOGY ASSOCIATES
Organization subpart
Yes
Provider details
NPI number
Legal business name
IU RADIOLOGY ASSOCIATES
Authorized official
MR. RANDALL J LUCKEY (SECRETARY, TREASURER)
(317) 472-4565
Entity
Organization
Contact information
Practice address
250 N SHADELAND AVE, STE 200, INDIANAPOLIS, IN 46219-4959
(317) 962-4836
(317) 962-4391
Mailing address
714 N SENATE AVE, STE 100, INDIANAPOLIS, IN 46202-3763
(317) 962-4836
(317) 962-4391
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12010577
IN
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
12010577
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201129790
—
IN
Enumeration date
12/17/2012
Last updated
06/05/2013
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