Organization
OPEN MRI OF AUBURN OPELIKA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOMMY R HARRIS (MANAGING MEMBER CEO)
(256) 533-2311
Entity
Organization
Contact information
Practice address
1441 GATEWAY DR, SUITE 1, OPELIKA, AL 36801-5462
(256) 533-2311
(256) 533-2231
Mailing address
PO BOX 18006, HUNTSVILLE, AL 35804-8006
(256) 533-2311
(256) 533-2231
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00359806
MEDICARE RR PALMETTO GBA
AL
Enumeration date
08/25/2006
Last updated
02/22/2008
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