| Organization Name: | GEAUGA COMMUNITY IMAGING, LLC |
| NPI Number: | 1043261977 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JACK C CORNELL (PRESIDENT) |
| Mailing Address: | 5192 Chillicothe Rd Suite 102 Chagrin Falls |
| State: | OH US |
| Postal Code: | 440224196 |
| Phone Number: | 4403388959 |
| Fax Number: | 4403385652 |
| NPI Enumeration Date: | 05/15/2006 |
| NPI Last Update Date: | 10/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | 03D0840101 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |