Organization
DIAGNOSTIC MEDICAL IMAGING ASSOCIATES, PSC.
Active
Other names
DMIA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERI P. IRWIN MD (PRESIDENT)
(502) 584-0128
Entity
Organization
Contact information
Practice address
3900 DUPONT SQ S, SUITE B, LOUISVILLE, KY 40207-4615
(502) 584-0128
(502) 584-0149
Mailing address
1108 DUPONT CIR, LOUISVILLE, KY 40207-4804
(502) 897-0139
(502) 897-5337
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65914947
—
KY
01
—
CC2698
RAILROAD MEDICARE
KY
Enumeration date
04/04/2006
Last updated
10/19/2007
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