Provider Demographics
NPI:1205068608
Name:MOBILE DIAGNOSTICS, INC
Entity type:Organization
Organization Name:MOBILE DIAGNOSTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:865-584-3926
Mailing Address - Street 1:4605 PAPERMILL DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1971
Mailing Address - Country:US
Mailing Address - Phone:865-584-3926
Mailing Address - Fax:865-584-3645
Practice Address - Street 1:4605 PAPERMILL DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1971
Practice Address - Country:US
Practice Address - Phone:865-584-3926
Practice Address - Fax:865-584-3645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SX0106XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOccupational HealthGroup - Single Specialty