Provider Demographics
NPI:1912292988
Name:ST. THOMAS RADIOLOGY ASSOCIATES, LLC
Entity type:Organization
Organization Name:ST. THOMAS RADIOLOGY ASSOCIATES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:I
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:340-774-0265
Mailing Address - Street 1:PO BOX 11839
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-4839
Mailing Address - Country:US
Mailing Address - Phone:340-774-0265
Mailing Address - Fax:340-776-0228
Practice Address - Street 1:SUNNY ISLE SHOPP CTR SPC B-2
Practice Address - Street 2:
Practice Address - City:ST CROIX
Practice Address - State:VI
Practice Address - Zip Code:00820-4493
Practice Address - Country:US
Practice Address - Phone:340-778-5840
Practice Address - Fax:340-778-5844
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. THOMAS RADIOLOGY ASSOCIATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI7452085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty