Provider Demographics
NPI:1083674287
Name:VALLEY RADIOLOGY, P.A.
Entity Type:Organization
Organization Name:VALLEY RADIOLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:REICHLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-259-2323
Mailing Address - Street 1:1108B S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-2514
Mailing Address - Country:US
Mailing Address - Phone:256-259-2323
Mailing Address - Fax:256-259-9397
Practice Address - Street 1:1108B S BROAD ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-2514
Practice Address - Country:US
Practice Address - Phone:256-259-2323
Practice Address - Fax:256-259-9397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL60273Medicaid
AL60273Medicaid