| NPI | 1497712160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL J LUCKEY Executive Director 317-962-4836 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 1223X0008X Dentist, Oral and Maxillofacial Radiology |
| 2085B0100X Radiology, Body Imaging | |
| 2085N0700X Radiology, Neuroradiology | |
| 2085N0904X Radiology, Nuclear Radiology | |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| 2085U0001X Radiology, Diagnostic Ultrasound | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2007-11-05 |