Basic Information
| Provider Information | |||||||||
| NPI: | 1245290857 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RADIOLOGY IMAGING ASSOCIATES OF OAK RIDGE PC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | RADIOLOGY IMAGING ASSOCIATES OF OAK RIDGE | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 DODDS AVE | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374043911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4238268220 | ||||||||
| FaxNumber: | 4236983622 | ||||||||
| Practice Location | |||||||||
| Address1: | 990 OAK RIDGE TPKE | ||||||||
| Address2: | |||||||||
| City: | OAK RIDGE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378306976 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8654811162 | ||||||||
| FaxNumber: | 8654811863 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | TRAMONTANA | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8658354600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | TN | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 202663 | 01 | TN | BLSCK LUNG | OTHER | 3374498 | 01 | TN | PHP/CARITEN | OTHER | 1640852 | 01 | TN | UHC | OTHER | 3374498 | 05 | TN | MEDICAID | 4023259 | 01 | TN | BC/BS OF TN | OTHER | 166689000 | 01 | TN | DOL | OTHER | 65935223 | 05 | KY | MEDICAID |