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Organization

ADVANCD DIAGNOSTIC IMAGING, PC

Active
Parent organization
ADVANCD DIAGNOSTIC IMAGING, PC
Other names
Covenant Medical Group
Organization subpart
Yes

Provider details

NPI number
Legal business name
ADVANCD DIAGNOSTIC IMAGING, PC
Authorized official
SUSAN FENTON (CREDENTIALING SUPERVISOR)
(615) 851-6033
Entity
Organization

Contact information

Practice address
200 CREEKSIDE DR, DICKSON, TN 37055-2176
(615) 851-6033
Mailing address
3024 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072-3132
(615) 851-6033

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3372986
TN
Enumeration date
10/24/2018
Last updated
10/24/2018
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