Organization Name: | KODIAK BOARD CERTIFIED RADIOLOGY, LLC |
NPI Number: | 1295032910 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KAY E. BIAS (EXECUTIVE DIRECTOR) |
Mailing Address: | 1915 E Rezanof Dr Kodiak |
State: | AK US |
Postal Code: | 996156602 |
Phone Number: | 9074869581 |
Fax Number: | 9074869523 |
NPI Enumeration Date: | 02/15/2011 |
NPI Last Update Date: | 03/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 6152 |
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. |