Provider Demographics
NPI:1780708545
Name:DIGITAL SPINE DIAGNOSTICS, LLC
Entity type:Organization
Organization Name:DIGITAL SPINE DIAGNOSTICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-454-0047
Mailing Address - Street 1:1941 BISHOP LN
Mailing Address - Street 2:SUITE 710
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-1922
Mailing Address - Country:US
Mailing Address - Phone:502-454-0047
Mailing Address - Fax:
Practice Address - Street 1:1941 BISHOP LN
Practice Address - Street 2:SUITE 710
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-1922
Practice Address - Country:US
Practice Address - Phone:502-454-0047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY220707335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier