Provider Demographics
NPI:1083743231
Name:SPINAL SCAN
Entity Type:Organization
Organization Name:SPINAL SCAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER M EDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-851-5757
Mailing Address - Street 1:314 BLUEBIRD DR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-2304
Mailing Address - Country:US
Mailing Address - Phone:615-851-5757
Mailing Address - Fax:615-851-4607
Practice Address - Street 1:314 BLUEBIRD DR
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2304
Practice Address - Country:US
Practice Address - Phone:615-851-5757
Practice Address - Fax:615-851-4607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0093172471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty