Provider Demographics
NPI:1891800959
Name:COLUMBUS AREA RADIOLOGY LLC
Entity Type:Organization
Organization Name:COLUMBUS AREA RADIOLOGY LLC
Other - Org Name:COLUMBUS DIAGNOSTIC IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-376-1000
Mailing Address - Street 1:790 CREEKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-2606
Mailing Address - Country:US
Mailing Address - Phone:812-376-1000
Mailing Address - Fax:812-376-6665
Practice Address - Street 1:790 CREEKVIEW DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-2606
Practice Address - Country:US
Practice Address - Phone:812-376-1000
Practice Address - Fax:812-376-6665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN069680Medicare ID - Type UnspecifiedPROVIDER NUMBER