Provider Demographics
NPI:1831465772
Name:MOBILE ULTRASOUND SPECIALISTS, INC
Entity Type:Organization
Organization Name:MOBILE ULTRASOUND SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CHRISTY
Authorized Official - Last Name:MCGREGOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-788-6693
Mailing Address - Street 1:784 FOXHOUND DR
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32128-7003
Mailing Address - Country:US
Mailing Address - Phone:386-788-6693
Mailing Address - Fax:
Practice Address - Street 1:784 FOXHOUND DR
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32128-7003
Practice Address - Country:US
Practice Address - Phone:386-788-6693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile