Organization
SOUTHEAST RADIOLOGY LTD
Active
Organization
SOUTHEAST RADIOLOGY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HIEHLE MD (PRESIDENT)
(610) 447-2500
Entity
Organization
Contact information
Practice address
1 MEDICAL CENTER BLVD, CHESTER, PA 19013-3902
(610) 447-2517
(610) 956-0069
Mailing address
PO BOX 3247, EVANSVILLE, IN 47731-3247
(800) 467-2392
(812) 471-6650
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
MD015422E
PA
2085R0202X
Diagnostic Radiology Physician
Primary
MD015422E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009311400027
—
PA
Enumeration date
09/07/2005
Last updated
07/07/2022
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