Provider Demographics
NPI:1841235041
Name:RADIOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:RADIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EARL
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:406-265-5827
Mailing Address - Street 1:PO BOX 1540
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-1540
Mailing Address - Country:US
Mailing Address - Phone:406-265-5827
Mailing Address - Fax:406-265-5949
Practice Address - Street 1:30 13TH ST
Practice Address - Street 2:
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-5222
Practice Address - Country:US
Practice Address - Phone:406-265-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4750174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000008456Medicare PIN