Provider Demographics
NPI:1891795753
Name:RADIOLOGY PHYSICIANS OF SPRINGFIELD
Entity Type:Organization
Organization Name:RADIOLOGY PHYSICIANS OF SPRINGFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FREDDY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KATAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:934-390-5000
Mailing Address - Street 1:PO BOX 713170
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43271-3170
Mailing Address - Country:US
Mailing Address - Phone:866-684-1485
Mailing Address - Fax:
Practice Address - Street 1:1343 N FOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1422
Practice Address - Country:US
Practice Address - Phone:937-390-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2538267Medicaid
OH2538141Medicaid
OH2538132Medicaid
OH2538276Medicaid
OH2538329Medicaid
OH2293898Medicaid
OH2538329Medicaid