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Organization

MEMPHIS RADIOLOGICAL, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DALE E HANSEN JR. MD (PRESIDENT)
(901) 685-2696
Entity
Organization

Contact information

Practice address
1265 UNION AVE, MEMPHIS, TN 38104-3415
(901) 685-2696
(423) 826-1290
Mailing address
DEPT 24 PO BOX 1000, MEMPHIS, TN 38148
(901) 685-2696
(423) 826-1290

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3370135
TN
01
CC0445
RR MEDICARE
TN
Enumeration date
05/23/2005
Last updated
07/21/2022
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