Organization
X-RAY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD S GORDON M.D. (PRESIDENT)
(419) 303-6805
Entity
Organization
Contact information
Practice address
1001 BELLEFONTAINE AVE, RADIOLOGY DEPARTMENT, LIMA, OH 45804-2800
(419) 226-5055
(419) 226-5064
Mailing address
967 BELLEFONTAINE AVE, SUITE 200, LIMA, OH 45804-2888
(419) 225-6346
(419) 225-6609
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000024953
ANTHEM
OH
05
—
0517686
—
OH
05
—
2212411
—
OH
01
—
CF7375
RAILROAD MEDICARE
—
Enumeration date
07/26/2006
Last updated
09/11/2025
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