Provider Demographics
NPI:1386957942
Name:LAKE CITY DIAGNOSTIC IMAGING, INC.
Entity type:Organization
Organization Name:LAKE CITY DIAGNOSTIC IMAGING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MURAT
Authorized Official - Middle Name:
Authorized Official - Last Name:CAGLAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-342-2400
Mailing Address - Street 1:23 MAIN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29926-6606
Mailing Address - Country:US
Mailing Address - Phone:843-342-2400
Mailing Address - Fax:843-342-5898
Practice Address - Street 1:148 SAULS ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:SC
Practice Address - Zip Code:29560-2631
Practice Address - Country:US
Practice Address - Phone:843-374-0450
Practice Address - Fax:843-374-0451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-23
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center