Organization
MEDCOM IMAGING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARRETT KUNA (COO)
(479) 213-2546
Entity
Organization
Contact information
Practice address
11 SHERWOOD LN, CLARKSVILLE, AR 72830-4500
(479) 213-2546
Mailing address
102 N 17TH ST, OZARK, AR 72949-2349
(479) 213-2546
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04152018
PRIVATE PROVIDER
AR
Enumeration date
07/17/2019
Last updated
07/17/2019
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