Provider Demographics
NPI:1336137090
Name:PARLEE & TATEM RADIOLOGIC ASSOCIATES, LTD.
Entity type:Organization
Organization Name:PARLEE & TATEM RADIOLOGIC ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:KESACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-345-2290
Mailing Address - Street 1:PO BOX 830624
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0624
Mailing Address - Country:US
Mailing Address - Phone:800-666-1816
Mailing Address - Fax:706-653-0615
Practice Address - Street 1:595 W STATE ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2554
Practice Address - Country:US
Practice Address - Phone:610-372-4957
Practice Address - Fax:610-372-3735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-07
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009249600014Medicaid
PA0009249600014Medicaid