Hayden O Jack in Fort Worth - Diagnostic Radiology
Hayden O Jack - NPI 1093795338
Hayden O Jack is a Diagnostic Radiology in Fort Worth, Texas. Hayden O Jack practices all healthcare services and medical treatments related to Diagnostic Radiology. The NPI Number for Hayden O Jack is 1093795338. The last update date is 2017-04-28.
Hayden O Jack's current location address is 816 W Cannon St, Fort Worth, Texas. You can contact this provider via phone number 8173210404. The mailing address for Hayden O Jack is 816 W Cannon St, Fort Worth, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Hayden O Jack |
|---|---|
| Address | 816 W Cannon St, Fort Worth, Texas |
| Phone Number | 8173210404 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1093795338 |
|---|---|
| Provider Enumeration Date | 2006-01-20 |
| Last Updated Date | 2017-04-28 |
Provider Mailing Address Detail
| Address | 816 W Cannon St |
|---|---|
| City | Fort Worth |
| State | Texas (TX) |
| Post Code | 761043146 |
| Phone Number | 8173210404 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Diagnostic Radiology |
|---|---|
| Taxonomy | 2085R0202X |
| Licence No | 101054381 |
|
Definition: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 121715004 | TX | -- | |
| 121715008 | TX | -- | |
| 285250101 | TX | -- |
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What is the unique 10-digit identification code issued to Hayden O Jack by the Centers for Medicare & Medicaid Services?
The Hayden O Jack has been assigned the NPI (National Provider Identifier) 1093795338 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Hayden O Jack's physical address?
The Hayden O Jack is physically located at 816 W Cannon St, in the city of Fort Worth, TX, with the postal code 761043146.
What is Hayden O Jack's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Hayden O Jack is Diagnostic Radiology, and the taxonomy code that classifies this field of practice is 2085R0202X.
On what date did Hayden O Jack receive its 1093795338 assignment from the Centers for Medicare & Medicaid Services?
The Hayden O Jack was assigned its 1093795338 on 2006-01-20, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Hayden O Jack's details last updated?
The information pertaining to the Hayden O Jack, including its address, specialty, and other details, was most recently updated on 2017-04-28.
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