Provider Demographics
NPI:1275739930
Name:DIAGNOSTIC IMAGING CONSULTANTS,LTD
Entity Type:Organization
Organization Name:DIAGNOSTIC IMAGING CONSULTANTS,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:HARPOLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:270-534-8999
Mailing Address - Street 1:PO BOX 7287
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-7287
Mailing Address - Country:US
Mailing Address - Phone:270-534-8999
Mailing Address - Fax:270-534-1670
Practice Address - Street 1:215 HAWKS RD STE 4
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237
Practice Address - Country:US
Practice Address - Phone:270-534-8999
Practice Address - Fax:270-534-1670
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIAGNOSTIC IMAGING CONSULTANTS,LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-21
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65934234Medicaid
TN3375396Medicaid
TN3375396Medicaid