Provider Demographics
NPI:1528519949
Name:HOBBIE RADIOLOGY
Entity type:Organization
Organization Name:HOBBIE RADIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-357-9864
Mailing Address - Street 1:101 GREENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-9152
Mailing Address - Country:US
Mailing Address - Phone:570-290-0234
Mailing Address - Fax:570-300-2790
Practice Address - Street 1:101 GREENFIELD DR
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-9152
Practice Address - Country:US
Practice Address - Phone:570-290-0234
Practice Address - Fax:570-586-8206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0539272085R0202X
MEMD204812085R0202X
FLME1239412085R0202X
NY2022922085R0202X
WV263572085R0202X
PAMD058608L2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001604197Medicaid
PAG19639Medicare UPIN