Provider Demographics
NPI:1285628198
Name:ENDOVASCULAR IMAGING PARTNERS II, LLC
Entity Type:Organization
Organization Name:ENDOVASCULAR IMAGING PARTNERS II, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOCKHART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-892-5794
Mailing Address - Street 1:29101 HEALTH CAMPUS DR
Mailing Address - Street 2:BUILDING 2 SUITE 155
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5270
Mailing Address - Country:US
Mailing Address - Phone:440-892-5794
Mailing Address - Fax:440-892-5798
Practice Address - Street 1:29101 HEALTH CAMPUS DR
Practice Address - Street 2:BUILDING 2 SUITE 155
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5270
Practice Address - Country:US
Practice Address - Phone:440-892-5794
Practice Address - Fax:440-892-5798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350619822085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2430337Medicaid
OH2430337Medicaid
OHENID01831Medicare PIN