| Organization Name: | TALLAHASSEE DIAGNOSTIC IMAGING CENTER LTD |
| NPI Number: | 1639129521 |
| 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: | 8508789729 |
| NPI Enumeration Date: | 05/11/2006 |
| NPI Last Update Date: | 06/11/2015 |
| 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. |