Basic Information
| Provider Information | |||||||||
| NPI: | 1508847922 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDICAL IMAGING PHYSICIANS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2591 MIAMISBURG CENTERVILLE RD | ||||||||
| Address2: | STE. 302 | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454593711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374337622 | ||||||||
| FaxNumber: | 9374337656 | ||||||||
| Practice Location | |||||||||
| Address1: | 2591 MIAMISBURG CENTERVILLE RD | ||||||||
| Address2: | STE. 302 | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454593711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374337622 | ||||||||
| FaxNumber: | 9374337656 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2005 | ||||||||
| LastUpdateDate: | 02/07/2008 | ||||||||
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| AuthorizedOfficialLastName: | HAMILTON | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9374337622 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CMM | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 0844984 | 05 | OH | MEDICAID |