Organization
ENTERPRISE OPEN MRI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN C. TOMBERLIN M.D. (OWNER)
(334) 684-7156
Entity
Organization
Contact information
Practice address
100 PROFESSIONAL LANE SUITE B, ENTERPRISE, AL 36330
(334) 308-1524
(334) 308-1528
Mailing address
194 E. REDSTONE AVE. SUITE A, CRESTVIEW, FL 32539-5348
(334) 684-7156
(334) 684-7709
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051519465
BLUE CROSS
—
05
—
051554517
—
AL
Enumeration date
07/27/2006
Last updated
12/09/2010
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