Organization
ADVANCED DIAGNOSTIC IMAGING, PC
Active
Parent organization
ADVANCED DIAGNOSTIC IMAGING, PC
Other names
Covenant Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVANCED DIAGNOSTIC IMAGING, PC
Authorized official
SUSAN FENTON (CREDENTIALING SUPERVISOR)
(615) 851-6033
Entity
Organization
Contact information
Practice address
2340 FAIRVIEW BOULEVARD, SUITE 600D, FAIRVIEW, TN 37062
(615) 441-6140
Mailing address
3024 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072-3132
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
10/29/2018
Last updated
02/14/2020
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