Provider Demographics
NPI:1386678092
Name:METROAMERICAN RADIOLOGY CONSULTANTS P A
Entity Type:Organization
Organization Name:METROAMERICAN RADIOLOGY CONSULTANTS P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-985-7180
Mailing Address - Street 1:P O BOX 635001
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5001
Mailing Address - Country:US
Mailing Address - Phone:865-985-7185
Mailing Address - Fax:865-692-3390
Practice Address - Street 1:1431 CENTERPOINT BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-1984
Practice Address - Country:US
Practice Address - Phone:865-985-7185
Practice Address - Fax:865-560-7379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000000215752OtherANTHEM BCBS
GA605948801OtherFECA, BLACK LUNG, ENERGY
INCJ9013OtherRAILROAD MCARE
IN200387190BMedicaid
GADC7006OtherRAILROAD
IN200387190BMedicaid
ID000000215752OtherANTHEM BCBS
GA605948801OtherFECA, BLACK LUNG, ENERGY
IN200387190BMedicaid