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Organization

ASSOCIATED RADIOLOGISTS OF CLARKSTON PLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIMOTHY R O'NEILL D.O. (CEO)
(248) 625-2621
Entity
Organization

Contact information

Practice address
7210 ORTONVILLE RD. STE 211, CLARKSTON, MI 48346
(248) 625-2621
Mailing address
6770 DIXIE HWY STE 200, CLARKSTON, MI 48346-2089
(248) 625-2621
(248) 922-5973

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301045208
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4996896
MI
05
5187744
MI
Enumeration date
12/06/2006
Last updated
10/15/2007
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