Organization
RADIOLOGISTS PA
Active
Parent organization
RADIOLOGISTS PA
Other names
Prime Medical Imaging
Organization subpart
Yes
Provider details
NPI number
Legal business name
RADIOLOGISTS PA
Authorized official
GREGG S. DANIELS (ADMINISTRATOR)
(479) 452-9416
Entity
Organization
Contact information
Practice address
5707 JENNY LIND RD, FORT SMITH, AR 72908-7435
(479) 452-9416
(479) 484-0827
Mailing address
PO BOX 3887, FORT SMITH, AR 72913-3887
(479) 452-9416
(479) 484-0827
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100726820A
—
OK
05
—
105694002
—
AR
Enumeration date
03/03/2006
Last updated
04/30/2019
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