Provider Demographics
NPI:1831237791
Name:KNOX RADIOLOGY ASSOCIATES LLC
Entity type:Organization
Organization Name:KNOX RADIOLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KINGSLEY
Authorized Official - Middle Name:ATTOH
Authorized Official - Last Name:ORRACA-TETTEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-393-9044
Mailing Address - Street 1:1575 YAUGER RD
Mailing Address - Street 2:SUITE 43
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-8294
Mailing Address - Country:US
Mailing Address - Phone:740-393-9044
Mailing Address - Fax:740-393-9911
Practice Address - Street 1:1330 COSHOCTON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-1440
Practice Address - Country:US
Practice Address - Phone:740-393-9044
Practice Address - Fax:740-393-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350595742085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty