Organization
MEDICAL IMAGING CONSULTANTS LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY KEATON MD (PRESIDENT)
(903) 918-6525
Entity
Organization
Contact information
Practice address
700 E MARSHALL AVE, LONGVIEW, TX 75601-5580
(903) 315-2072
(903) 247-0222
Mailing address
1602 PINE TREE RD, SUITE 3, LONGVIEW, TX 75604-3273
(903) 759-8886
(903) 247-0222
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00K61Q
BLUE CROSS BLUE SHIELD TX
TX
01
—
015922
TX KIDNEY HEALTH
TX
01
—
023218301
CIDC
TX
01
—
093656901
COUNTY AGENCY
TX
05
—
093656901
—
TX
01
—
DA2958
TRAVELERS MEDICARE
TX
Enumeration date
05/03/2006
Last updated
03/07/2019
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