Provider Demographics
NPI:1215931290
Name:ASSOCIATED RADIOLOGISTS, LTD.
Entity type:Organization
Organization Name:ASSOCIATED RADIOLOGISTS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPERANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-910-6654
Mailing Address - Street 1:800 S CHURCH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4154
Mailing Address - Country:US
Mailing Address - Phone:870-910-6654
Mailing Address - Fax:870-932-0526
Practice Address - Street 1:225 E JACKSON AVE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3119
Practice Address - Country:US
Practice Address - Phone:870-910-6654
Practice Address - Fax:870-932-0526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMC02222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR101720702Medicaid
MO508889805Medicaid
MO508889805Medicaid