JACKSON RADIOLOGY ASSOCIATES PA NPI 1699700716

NPI Information

NPI: 1699700716
Provider Name: JACKSON RADIOLOGY ASSOCIATES PA
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
620 SKYLINE DR
JACKSON, TN
ZIP 38301
Phone: (731) 541-6174
Get Directions

JACKSON RADIOLOGY ASSOCIATES PA is a diagnostic radiology radiology in Jackson, TN. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. JACKSON RADIOLOGY ASSOCIATES PA NPI is 1699700716. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

620 SKYLINE DR
JACKSON, TN
ZIP 38301-901
Phone: (731) 541-6174
Fax: (731) 425-6274

The provider's authorized official is Gregory Bruno .
The authorized official title is President and has the following contact phone number (731) 541-6174.

The enumeration date for this NPI number is 7/11/2006 and was last updated on 3/11/2024.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	2085B0100X	Radiology	Body Imaging	No
2	2085N0700X	Radiology	Neuroradiology	No
3	2085N0904X	Radiology	Nuclear Radiology	No
4	2085P0229X	Radiology	Pediatric Radiology	No
5	2085R0001X	Radiology	Radiation Oncology	No
6	2085R0202X	Radiology	Diagnostic Radiology	Yes
7	2085R0203X	Radiology	Therapeutic Radiology	No
8	2085R0204X	Radiology	Vascular & Interventional Radiology	No
9	2085R0205X	Radiology	Radiological Physics	No
10	2085U0001X	Radiology	Diagnostic Ultrasound	No
11	363L00000X	Nurse Practitioner		No

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3729238	MEDICAID	TENNESSEE
2	315752	OTHER	COLORADO	MEDICARE PIN
3	CG710B	OTHER		NEVADA MEDICARE
4	CG753Z	OTHER	CALIFORNIA	CALIFORNIA MDCR
5	DD9799	OTHER		RAILROAD MEDICARE
6	CG710C	OTHER	HAWAII	PALMETTO HAWAII

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

NPI Synchronization or Removal

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