Organization
DYNAMIC RADIOLOGY TENNESSEE, PC
Active
Organization
DYNAMIC RADIOLOGY TENNESSEE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARID THANAWALLA MD (MEDICAL DIRECTOR)
(248) 388-5005
Entity
Organization
Contact information
Practice address
651 DUNLOP LN, CLARKSVILLE, TN 37040
(615) 788-9324
Mailing address
919 CONFERENCE DR., SUITE 4 BOX 167, GOODLETTSVILLE, TN 37072-1924
(615) 788-9324
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Enumeration date
09/20/2022
Last updated
01/27/2023
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