National Provider Identifier Database

FORT WAYNE RADIOLOGY ASSOCIATES LLC
Diagnostic Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.


Contact Information

FORT WAYNE RADIOLOGY ASSOCIATES LLC
3707 NEW VISION DR
FORT WAYNE, IN46845
Phone: 260-471-9466
Fax: 260-484-5919
Website:
Specialty Taxonomy Code
* Diagnostic Radiology 2085R0202X

* Indicates primary specialty

NPI Profile & details for FORT WAYNE RADIOLOGY ASSOCIATES LLC

NPI Number 1063475861
Legal business name
LBN
FORT WAYNE RADIOLOGY ASSOCIATES LLC
Authorized official MICHAEL KINZER - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 04/11/2006
Last updated 07/10/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • IN Medicaid: 200176030A

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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