Provider Demographics
NPI:1679025522
Name:DIAGNOSTIC IMAGING PARTNERS
Entity Type:Organization
Organization Name:DIAGNOSTIC IMAGING PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:BEARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:910-762-3882
Mailing Address - Street 1:1025 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7354
Mailing Address - Country:US
Mailing Address - Phone:910-762-3882
Mailing Address - Fax:910-343-6021
Practice Address - Street 1:2000 BRABHAM AVENUE
Practice Address - Street 2:SUITE 110
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546
Practice Address - Country:US
Practice Address - Phone:910-939-3110
Practice Address - Fax:910-332-5132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty