Provider Demographics
NPI:1194804906
Name:INDEPENDENT RADIOLOGY ASSOCIATES PLC
Entity type:Organization
Organization Name:INDEPENDENT RADIOLOGY ASSOCIATES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:P
Authorized Official - Last Name:CATON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-285-2346
Mailing Address - Street 1:PO BOX 1296
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38025-1296
Mailing Address - Country:US
Mailing Address - Phone:731-285-2346
Mailing Address - Fax:731-285-4717
Practice Address - Street 1:400 E TICKLE ST
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024
Practice Address - Country:US
Practice Address - Phone:731-285-2346
Practice Address - Fax:731-285-4717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3705496Medicaid
TN3705496Medicaid