Provider Demographics
NPI:1437490794
Name:MAMMOGRAPHY AND ULTRASOUND IMAGING CENTER
Entity Type:Organization
Organization Name:MAMMOGRAPHY AND ULTRASOUND IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:YANCEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-727-4911
Mailing Address - Street 1:7550 W UNIVERSITY AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-7607
Mailing Address - Country:US
Mailing Address - Phone:352-727-4911
Mailing Address - Fax:
Practice Address - Street 1:7550 W UNIVERSITY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-7607
Practice Address - Country:US
Practice Address - Phone:352-727-4911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty