Provider Demographics
NPI:1235473448
Name:PRN IMAGING, LLC
Entity Type:Organization
Organization Name:PRN IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-956-5000
Mailing Address - Street 1:10851 MASTIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1608
Mailing Address - Country:US
Mailing Address - Phone:913-956-5000
Mailing Address - Fax:913-956-4955
Practice Address - Street 1:10851 MASTIN ST STE 100
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1608
Practice Address - Country:US
Practice Address - Phone:913-956-5000
Practice Address - Fax:913-956-4955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-26713207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty