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Organization

FORT PAYNE MRI LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES W. HOLMES (CHIEF OPERATING OFFICER)
(337) 291-9161
Entity
Organization

Contact information

Practice address
1110 GLENN BLVD SW, SUITE 100, FORT PAYNE, AL 35967-8486
(256) 845-9402
(256) 845-9410
Mailing address
1110 GLENN BLVD SW, SUITE 100, FORT PAYNE, AL 35967-8486
(256) 845-9402
(256) 845-9410

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
261QR0200X
Radiology Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051557560
AL
Enumeration date
04/25/2006
Last updated
03/04/2026
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