Provider Demographics
NPI:1588703946
Name:HENDRICKS COUNTY RADIOLOGY INC
Entity type:Organization
Organization Name:HENDRICKS COUNTY RADIOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-745-3425
Mailing Address - Street 1:PO BOX 727
Mailing Address - Street 2:
Mailing Address - City:CLOVERDALE
Mailing Address - State:IN
Mailing Address - Zip Code:46120-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1948
Practice Address - Country:US
Practice Address - Phone:317-745-3425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CJ0060OtherRAILROAD MEDICARE
IN139215XXOtherPREFERRED CARE
IN200009510BMedicaid
1453704OtherUNITED MINE WORKERS
CA2847OtherRAILRAOD MEDICARE
CA2847OtherRAILRAOD MEDICARE
IN=========OtherANTHEM
=========005OtherCHAMPUS
IN139215XXOtherPREFERRED CARE
IN611890Medicare PIN