Provider Demographics
NPI:1467407262
Name:RADIOLOGY CONSULTANTS OF WYTHEVILLE
Entity Type:Organization
Organization Name:RADIOLOGY CONSULTANTS OF WYTHEVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:A
Authorized Official - Last Name:RITCH
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:276-228-0367
Mailing Address - Street 1:PO BOX 13205
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24032-3205
Mailing Address - Country:US
Mailing Address - Phone:540-776-8337
Mailing Address - Fax:
Practice Address - Street 1:600 W RIDGE RD
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-1044
Practice Address - Country:US
Practice Address - Phone:276-228-0367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC00924Medicare ID - Type Unspecified