Provider Demographics
NPI:1144414335
Name:NWA SURGEON INVESTORS, LLC
Entity Type:Organization
Organization Name:NWA SURGEON INVESTORS, LLC
Other - Org Name:PHYSICIANS' MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:BLANKENSHIP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-521-5100
Mailing Address - Street 1:3873 N PARKVIEW DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-6286
Mailing Address - Country:US
Mailing Address - Phone:479-521-5100
Mailing Address - Fax:479-521-5101
Practice Address - Street 1:3873 N PARKVIEW DR
Practice Address - Street 2:SUITE 2
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-6286
Practice Address - Country:US
Practice Address - Phone:479-521-5100
Practice Address - Fax:479-521-5101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)