Provider Demographics
NPI:1427494855
Name:DOLPHIN RADIOLOGY PLLC
Entity type:Organization
Organization Name:DOLPHIN RADIOLOGY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
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:850-267-5667
Mailing Address - Street 1:585 MACK BAYOU RD
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-3111
Mailing Address - Country:US
Mailing Address - Phone:850-267-5667
Mailing Address - Fax:850-267-5666
Practice Address - Street 1:2257 TAYLOR RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7790
Practice Address - Country:US
Practice Address - Phone:334-270-9914
Practice Address - Fax:334-270-3195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty