Organization
ADVANCED IMAGING OF ALABAMA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNON H HAGER MD (OWNER/PHYSICIAN)
(256) 549-0008
Entity
Organization
Contact information
Practice address
1699 GOLDEN SPRINGS RD, ANNISTON, AL 36207-7097
(256) 835-0835
(256) 549-0401
Mailing address
820 SOUTH 4TH STREET, GADSDEN, AL 35901-5223
(256) 549-0008
(256) 549-0401
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
17729
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113978
—
AL
01
—
510-49315
BC/BS OF AL
AL
Enumeration date
10/23/2008
Last updated
09/26/2012
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