Provider Demographics
NPI:1295401602
Name:EXPERTUS IMAGING
Entity Type:Organization
Organization Name:EXPERTUS IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-459-8845
Mailing Address - Street 1:2718 SQUIRREL HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:TN
Mailing Address - Zip Code:37096-3526
Mailing Address - Country:US
Mailing Address - Phone:931-589-8901
Mailing Address - Fax:
Practice Address - Street 1:2718 SQUIRREL HOLLOW DR
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:TN
Practice Address - Zip Code:37096-3526
Practice Address - Country:US
Practice Address - Phone:931-589-8901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Multi-Specialty