Provider Demographics
NPI:1902517808
Name:BOONE MEDICAL IMAGING INC
Entity type:Organization
Organization Name:BOONE MEDICAL IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-470-4219
Mailing Address - Street 1:7355 E ORCHARD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2511
Mailing Address - Country:US
Mailing Address - Phone:303-762-0710
Mailing Address - Fax:303-806-9533
Practice Address - Street 1:7355 E ORCHARD RD STE 100
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2511
Practice Address - Country:US
Practice Address - Phone:303-762-0710
Practice Address - Fax:303-806-9533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty