Organization
OPEN MRI ON 280, LLC
Active
Other names
ImageSouth Homewood
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI BROWN (DIRECTOR OF BILLING)
(706) 256-3450
Entity
Organization
Contact information
Practice address
1 INDEPENDENCE PLZ STE 140, HOMEWOOD, AL 35209-2629
(205) 870-1979
(205) 870-1929
Mailing address
PO BOX 932602, ATLANTA, GA 31193-2602
(205) 870-1979
(205) 870-1929
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023040409
N. MELINDA BERGQUIST, MD
AL
01
—
1124000344
RUTH SNOW, MD
AL
01
—
1235111451
DR. CECIL ELAND - NPI NUMBER
AL
01
—
1306051164
JAMES SPANN, M.D, NPI #
AL
01
—
1427030642
ROBERT EICHELBERGER, MD
AL
01
—
1600679
UHC - PROVIDER NUMBER
AL
01
—
470001761
RAILROAD MEDICARE
AL
01
—
51116995
JAMES SPANN, M.D. - BCBS ID #
AL
01
—
51511247
BCBS - FACILITY ID #
AL
05
—
529913290
—
AL
Enumeration date
01/30/2006
Last updated
10/28/2020
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