GREEN BAY RADIOLOGY SC NPI 1447327986

NPI Information

NPI: 1447327986
Provider Name: GREEN BAY RADIOLOGY SC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
2941 S RIDGE RD
GREEN BAY, WI
ZIP 54304
Phone: (920) 336-4096
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GREEN BAY RADIOLOGY SC is a diagnostic radiology radiology in Green Bay, WI. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. GREEN BAY RADIOLOGY SC NPI is 1447327986. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2941 S RIDGE RD
GREEN BAY, WI
ZIP 54304-517
Phone: (920) 336-4096
Fax: (920) 336-8093

The provider's authorized official is Jimmy Dado .
The authorized official title is Authorized Offical and has the following contact phone number (614) 325-8899.

The enumeration date for this NPI number is 11/29/2006 and was last updated on 3/19/2024.

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	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology		WISCONSIN	Yes
2	2085R0204X	Radiology	Vascular & Interventional Radiology		WISCONSIN	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	32692400	MEDICAID	WISCONSIN

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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