Organization
RAD-ONE, PA
Active
Other names
Diagnostic Imaging Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
YVETTE M REYNOLDS (MEDICAL BILLING COORDINATOR)
(716) 435-5044
Entity
Organization
Contact information
Practice address
7420 GUTHRIE DR N, SOUTHAVEN, MS 38671-5876
(662) 349-4321
(662) 996-1533
Mailing address
618 FREDERICK DR, CLEVELAND, MS 38732-2006
(716) 435-5044
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015498
—
MS
01
—
5F243
BLUE CROSS & BLUE SHIELD
AR
01
—
DD5320
MS RAILROAD MEDICARE
MS
Enumeration date
01/15/2007
Last updated
04/20/2008
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