Organization
RADIOLOGY ASSOCIATES OF TALLAHASSEE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R DETELICH (CEO)
(850) 878-4127
Entity
Organization
Contact information
Practice address
1002 N ARNOLD RD, STE 101, PANAMA CITY BEACH, FL 32413-2291
(850) 238-4100
(706) 653-1230
Mailing address
PO BOX 20747, TAMPA, FL 33622-0747
(800) 475-6112
(706) 653-1230
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Enumeration date
10/01/2024
Last updated
10/01/2024
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