Basic Information
| Provider Information | |||||||||
| NPI: | 1538127428 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RADIOLOGICAL CONSULTANTS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 MEADE ST | ||||||||
| Address2: | STE 201B | ||||||||
| City: | DUNMORE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 185123195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705586858 | ||||||||
| FaxNumber: | 5705586857 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 QUINCY AVE | ||||||||
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| City: | SCRANTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 185101724 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5703074225 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2006 | ||||||||
| LastUpdateDate: | 08/11/2015 | ||||||||
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| AuthorizedOfficialLastName: | CUTILLO | ||||||||
| AuthorizedOfficialFirstName: | DOUGLAS | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5705586858 | ||||||||
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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 | 2085R0204X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 2085R0202X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.