Organization
PROSCAN TYLERSVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN AMAYA (COO)
(513) 281-3400
Entity
Organization
Contact information
Practice address
7003 LOOMIS LN, LIBERTY TOWNSHIP, OH 45069-3898
(513) 759-7350
(513) 759-7351
Mailing address
7003 LOOMIS LN, LIBERTY TOWNSHIP, OH 45069-3898
(513) 759-7350
(513) 759-7351
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0868IC
OH
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000332731
ANTHEM PIN
OH
05
—
2356203
—
OH
Enumeration date
10/28/2005
Last updated
09/12/2024
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