Provider Demographics
NPI:1720701543
Name:MEMPHIS RADIOLOGICAL, P.C.
Entity Type:Organization
Organization Name:MEMPHIS RADIOLOGICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-685-2696
Mailing Address - Street 1:P O BOX 1000 DEPT 24
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-685-2696
Mailing Address - Fax:
Practice Address - Street 1:6401 POPLAR AVE STE 100
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4840
Practice Address - Country:US
Practice Address - Phone:901-387-2340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEMPHIS RADIOLOGICAL, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty