Provider Demographics
NPI:1164894200
Name:SPECIALTY IMAGING
Entity Type:Organization
Organization Name:SPECIALTY IMAGING
Other - Org Name:RESILIENCE IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-955-4332
Mailing Address - Street 1:8610 EXPLORER DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1058
Mailing Address - Country:US
Mailing Address - Phone:719-955-4332
Mailing Address - Fax:719-955-4148
Practice Address - Street 1:99 INVERNESS DR E
Practice Address - Street 2:SUITE 110
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5118
Practice Address - Country:US
Practice Address - Phone:303-757-0332
Practice Address - Fax:303-757-0558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty