Provider Demographics
NPI:1336656487
Name:PHYSICIAN'S MOBILE X-RAY, INC
Entity Type:Organization
Organization Name:PHYSICIAN'S MOBILE X-RAY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:GELBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-561-4940
Mailing Address - Street 1:945 E PARK DR STE 102
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-2804
Mailing Address - Country:US
Mailing Address - Phone:717-561-4940
Mailing Address - Fax:717-561-4999
Practice Address - Street 1:4922 LASALLE RD
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3302
Practice Address - Country:US
Practice Address - Phone:301-864-2333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty