| Organization Name: | KODIAK DIAGNOSTIC IMAGING, PROFESSIONAL CORPORATION |
| NPI Number: | 1285899021 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARLOS E RIO (PRESIDENT) |
| Mailing Address: | 1915 E Rezanof Dr Kodiak |
| State: | AK US |
| Postal Code: | 996156602 |
| Phone Number: | 9075398997 |
| Fax Number: | |
| NPI Enumeration Date: | 07/22/2008 |
| NPI Last Update Date: | 07/22/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | 4924 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |