Provider Demographics
NPI:1912377508
Name:ALLY RADIOLOGY CONSULTANTS, LLC
Entity Type:Organization
Organization Name:ALLY RADIOLOGY CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:HOOVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-422-3424
Mailing Address - Street 1:1907 W FARMVILLE RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36879-4621
Mailing Address - Country:US
Mailing Address - Phone:205-422-3424
Mailing Address - Fax:334-384-9274
Practice Address - Street 1:1907 W FARMVILLE RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36879-4621
Practice Address - Country:US
Practice Address - Phone:205-422-3424
Practice Address - Fax:334-384-9274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.29612261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology