Mountain Telerad, Pllc in Mountain Home - Radiologic Technologist
Mountain Telerad, Pllc - NPI 1821280371
Mountain Telerad, Pllc is a Radiologic Technologist in Mountain Home, Idaho. Mountain Telerad, Pllc practices all healthcare services and medical treatments related to Radiologic Technologist. The NPI Number for Mountain Telerad, Pllc is 1821280371. The last update date is 2007-08-17.
Mountain Telerad, Pllc's current location address is 141 Victor Gust Dr, Mountain Home, Idaho. You can contact this provider via phone number 2085809524. The mailing address for Mountain Telerad, Pllc is 141 Victor Gust Dr, Mountain Home, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Mountain Telerad, Pllc |
|---|---|
| Address | 141 Victor Gust Dr, Mountain Home, Idaho |
| Phone Number | 2085809524 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Johnson Brent Micheal |
| Credentials | D.O. |
| Telephone Number | 2084557482 |
NPI Number Detail
| NPI Number | 1821280371 |
|---|---|
| Provider Enumeration Date | 2007-08-17 |
| Last Updated Date | 2007-08-17 |
Provider Mailing Address Detail
| Address | 141 Victor Gust Dr |
|---|---|
| City | Mountain Home |
| State | Idaho (ID) |
| Post Code | 836471654 |
| Phone Number | 2085809524 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Radiologic Technologist |
|---|---|
| Taxonomy | 247100000X |
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Definition: A medical imaging or radiation therapy professional who is appropriately educated and trained to perform medical imaging procedures using ionizing and nonionizing radiation. |
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Post Comment/ Review Below
What is the Mountain Telerad, Pllc's 1821280371?
The Mountain Telerad, Pllc's NPI (National Provider Identifier) Number is 1821280371. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Mountain Telerad, Pllc's facilities are geographically located?
The facilities of Mountain Telerad, Pllc are physically situated at the following location: 141 Victor Gust Dr, Mountain Home, ID, 836471654.
What is Mountain Telerad, Pllc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Mountain Telerad, Pllc's specialized field of practice is Radiologic Technologist, and the corresponding taxonomy code that categorizes this area of specialization is 247100000X.
On what date did the Mountain Telerad, Pllc receive its 1821280371 assignment from the Centers for Medicare & Medicaid Services?
The Mountain Telerad, Pllc was assigned its 1821280371 by the Centers for Medicare & Medicaid Services on 2007-08-17.
As of what date were the Mountain Telerad, Pllc's details last updated?
The information pertaining to the Mountain Telerad, Pllc, including its address, specialty, and other details, was most recently updated on 2007-08-17.