INTERVASC AT BAY RADIOLOGY LLC NPI 1942495916

NPI Information

NPI: 1942495916
Provider Name: INTERVASC AT BAY RADIOLOGY, LLC
Classification: Radiology - 2085R0204X
Entity Type: Organization

Specialization: Vascular & Interventional Radiology

Address:
527 N. PALO ALTO AVE.
PANAMA CITY, FL
ZIP 32401
Phone: (850) 873-3990
Get Directions

INTERVASC AT BAY RADIOLOGY, LLC is a vascular and interventional radiology radiology in Panama City, FL. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. INTERVASC AT BAY RADIOLOGY, LLC NPI is 1942495916. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

527 N. PALO ALTO AVE.
PANAMA CITY, FL
ZIP 32401-639
Phone: (850) 873-3990
Fax: (850) 873-3974

The provider's authorized official is Lloyd G. Logue .
The authorized official title is Ceo and has the following contact phone number (850) 747-4905.

The enumeration date for this NPI number is 9/12/2007 and was last updated on 8/18/2014.

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	2085R0204X	Radiology	Vascular & Interventional Radiology			Yes

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	279907300	MEDICAID	FLORIDA
2	98028	OTHER	FLORIDA	BCBS
3	AG442	MEDICARE PIN	FLORIDA

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: 11/14/2023

NPI Synchronization or Removal

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