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FORT WAYNE RADIOLOGY ASSOCIATES LLC NPI 1063475861


NPI Information

NPI: 1063475861
Provider Name: FORT WAYNE RADIOLOGY ASSOCIATES LLC

Doing Business As: DEXA DIAGNOSTICS

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
3707 NEW VISION DR
FORT WAYNE, IN
ZIP 46845
Phone: (260) 471-9466
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FORT WAYNE RADIOLOGY ASSOCIATES LLC is a diagnostic radiology radiology in Fort Wayne, IN. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. FORT WAYNE RADIOLOGY ASSOCIATES LLC NPI is 1063475861. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Dexa Diagnostics.

The provider's business location address is:

3707 NEW VISION DR
FORT WAYNE, IN
ZIP 46845
Phone: (260) 471-9466
Fax: (260) 484-5919

The provider's authorized official is Michael A Kinzer .
The authorized official title is President and has the following contact phone number (260) 471-9466.

The enumeration date for this NPI number is 4/11/2006 and was last updated on 7/10/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic RadiologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200176030AMEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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