Provider Demographics
NPI:1386684892
Name:MDO IMAGING ASSOCIATES PLC
Entity Type:Organization
Organization Name:MDO IMAGING ASSOCIATES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-733-0450
Mailing Address - Street 1:2222 S LINDEN RD
Mailing Address - Street 2:SUITE R
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-5475
Mailing Address - Country:US
Mailing Address - Phone:810-733-0450
Mailing Address - Fax:810-733-3445
Practice Address - Street 1:2222 S LINDEN RD
Practice Address - Street 2:SUITE R
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-5476
Practice Address - Country:US
Practice Address - Phone:810-733-0450
Practice Address - Fax:810-733-3445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI310B510660OtherBCBSM
MICE1787OtherRAILROAD MEDICARE
MI310B510660OtherBCBSM