Provider Demographics
NPI:1992936652
Name:KENNEWICK RADIOLOGY GROUP PC
Entity type:Organization
Organization Name:KENNEWICK RADIOLOGY GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:RHEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-941-4365
Mailing Address - Street 1:PO BOX 1441
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79105-1441
Mailing Address - Country:US
Mailing Address - Phone:509-586-5779
Mailing Address - Fax:
Practice Address - Street 1:3548 AVENIDA PANTERA
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8939
Practice Address - Country:US
Practice Address - Phone:509-586-5779
Practice Address - Fax:509-586-5178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty