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Contact Information

OUTPATIENT RADIOLOGY CLINIC PA
200 SOUTH ROHDES
STE B
WEST MEMPHIS, AR72301
 Phone: 870-735-5555
 Fax: 870-735-5660
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for OUTPATIENT RADIOLOGY CLINIC PA

NPI # 1265651459
LBN Legal business name OUTPATIENT RADIOLOGY CLINIC PA
Authorized official EDGAR FERGUSON - (PHYSICIAN RADIOLOGIST)
Entity Organization
Organization subpart 1 No
Enumeration date 04/25/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers
AR License # C6304
TN License # MD14662
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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