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Organization

DURHAM DIAGNOSTIC IMAGING LLC

Active
Other names
Independence Park
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GEOFFREY K. GARDNER (SVP FINANCE AND REVENUE CYCLE)
(336) 718-2078
Entity
Organization

Contact information

Practice address
4323 BEN FRANKLIN BLVD, DURHAM, NC 27704-2177
(919) 471-4840
(919) 321-1575
Mailing address
PO BOX 933393, ATLANTA, GA 31193-0001
(866) 659-1211
(336) 774-1751

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0187Q
BCBS NC
NC
01
205314600
DOL
NC
05
89014E3
NC
01
P00014222
MEDICARE RR
Enumeration date
05/04/2006
Last updated
03/20/2024
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