Provider Demographics
NPI:1588621296
Name:RADIOLOGY OF HUNTSVILLE, P.C.
Entity type:Organization
Organization Name:RADIOLOGY OF HUNTSVILLE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCCOWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-713-0647
Mailing Address - Street 1:2006 FRANKLIN ST., SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4537
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4537
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL890-51544OtherBCBS AL
AL243282Medicaid
AL243356Medicaid
AL512-34996OtherBCBS AL
AL512-35104OtherBCBS AL
ALQ029819Medicaid
AL200343Medicaid
AL266246Medicaid
AL512-35881OtherBCBS AL
AL201214Medicaid
AL243302Medicaid
AL245499Medicaid
AL511-92546OtherBCBS AL
AL890-44275OtherBCBS AL
AL199106Medicaid
AL511-92547OtherBCBS AL
AL200976Medicaid
AL201273Medicaid
AL511-92545OtherBCBS AL
AL512-08098OtherBCBS AL
AL512-34997OtherBCBS AL
AL512-35661OtherBCBS AL
AL200099Medicaid
AL212768Medicaid
AL243359Medicaid
AL511-92548OtherBCBS AL
AL511-92549OtherBCBS AL
AL1861653263OtherTRICARE
AL199636Medicaid
AL243952Medicaid
AL511-92544OtherBCBS AL
AL511-93661OtherBCBS AL