Provider Demographics
NPI:1679553895
Name:VISION RADIOLOGY PC
Entity Type:Organization
Organization Name:VISION RADIOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDSON
Authorized Official - Middle Name:L
Authorized Official - Last Name:KNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-596-6137
Mailing Address - Street 1:PO BOX 1647
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-1647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2949 WEST FRONT STREET
Practice Address - Street 2:
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641
Practice Address - Country:US
Practice Address - Phone:276-596-6137
Practice Address - Fax:276-596-5143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA332236OtherJOHN DEERE
DE1367OtherRAILROAD MEDICARE
WV3810004713Medicaid
DE1367OtherRAILROAD MEDICARE