Organization Name: | RADIOLOGY ASSOCIATES OF TALLAHASSEE PA |
NPI Number: | 1003866773 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN R DETELICH (CEO) |
Mailing Address: | 1600 Phillips Rd Tallahassee |
State: | FL US |
Postal Code: | 323085304 |
Phone Number: | 8508784127 |
Fax Number: | 8508780337 |
NPI Enumeration Date: | 05/11/2006 |
NPI Last Update Date: | 03/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |