Provider Demographics
NPI:1730290461
Name:ANDERSON RADIOLOGY ASSOCIATES LLP
Entity Type:Organization
Organization Name:ANDERSON RADIOLOGY ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:BSBA, RCC, CPC
Authorized Official - Phone:513-231-8885
Mailing Address - Street 1:7458 JAGER CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-4344
Mailing Address - Country:US
Mailing Address - Phone:513-231-8885
Mailing Address - Fax:513-231-5607
Practice Address - Street 1:7500 STATE RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-2439
Practice Address - Country:US
Practice Address - Phone:513-231-8885
Practice Address - Fax:513-231-5607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0967002Medicaid
OH0967002Medicaid