Provider Demographics
NPI:1972792596
Name:ORMOND RADIOLOGY PARTNERSHIP, LLC
Entity Type:Organization
Organization Name:ORMOND RADIOLOGY PARTNERSHIP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-673-3257
Mailing Address - Street 1:500 MEMORIAL CIR
Mailing Address - Street 2:SUITE B
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-5071
Mailing Address - Country:US
Mailing Address - Phone:386-673-3257
Mailing Address - Fax:
Practice Address - Street 1:500 MEMORIAL CIR
Practice Address - Street 2:SUITE B
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5071
Practice Address - Country:US
Practice Address - Phone:386-673-3257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty