Provider Demographics
NPI:1427030220
Name:RICHARD ARNO NELSON
Entity Type:Organization
Organization Name:RICHARD ARNO NELSON
Other - Org Name:ADVANCED IMAGING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ARNO
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:RDCS, RVT, RDMS, RTR
Authorized Official - Phone:931-766-1918
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-0219
Mailing Address - Country:US
Mailing Address - Phone:931-766-1918
Mailing Address - Fax:931-766-6410
Practice Address - Street 1:715 DOUGLAS DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-2764
Practice Address - Country:US
Practice Address - Phone:931-766-1918
Practice Address - Fax:931-766-0410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3790308Medicaid
TN3790308Medicare ID - Type Unspecified