Provider Demographics
NPI:1124887757
Name:PEAK INTERVENTIONAL RADIOLOGY, P.L.L.C.
Entity type:Organization
Organization Name:PEAK INTERVENTIONAL RADIOLOGY, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-319-6383
Mailing Address - Street 1:5515 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-9775
Mailing Address - Country:US
Mailing Address - Phone:509-319-6383
Mailing Address - Fax:
Practice Address - Street 1:13424 E MISSION AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-2759
Practice Address - Country:US
Practice Address - Phone:509-319-6383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty