Provider Demographics
NPI:1285477984
Name:BW MRI RADIOLOGY, PLLC
Entity type:Organization
Organization Name:BW MRI RADIOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:W
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-271-6736
Mailing Address - Street 1:PO BOX 242848
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-2848
Mailing Address - Country:US
Mailing Address - Phone:850-729-6747
Mailing Address - Fax:850-729-7279
Practice Address - Street 1:4536 E HIGHWAY 20 STE B
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-9755
Practice Address - Country:US
Practice Address - Phone:850-729-6747
Practice Address - Fax:850-729-7279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty