Provider Demographics
NPI:1467533299
Name:RADIOLOGY ASSOCIATES OF CANTON, INC
Entity Type:Organization
Organization Name:RADIOLOGY ASSOCIATES OF CANTON, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-218-9368
Mailing Address - Street 1:PO BOX 72384
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44192-0002
Mailing Address - Country:US
Mailing Address - Phone:330-493-0840
Mailing Address - Fax:330-493-7123
Practice Address - Street 1:875 8TH ST NE
Practice Address - Street 2:RADIOLOGY ASSOCIATES OF CANTON, INC - ATTN: CECILIA
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-8503
Practice Address - Country:US
Practice Address - Phone:330-832-8761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RADIOLOGY ASSOCIATES OF CANTON, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-18
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2627278Medicaid
OHDE0558OtherRAILROAD MEDICARE
OH000000378322OtherANTHEM BC/BS
OH=========00OtherBWC
OHDE0558OtherRAILROAD MEDICARE