Provider Demographics
NPI:1902912579
Name:MEDICAL RADIOLOGISTS INC
Entity Type:Organization
Organization Name:MEDICAL RADIOLOGISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:SORKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-296-0253
Mailing Address - Street 1:1563 E DOROTHY LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-3897
Mailing Address - Country:US
Mailing Address - Phone:937-296-0253
Mailing Address - Fax:937-293-3183
Practice Address - Street 1:2222 PHILADELPHIA DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-1813
Practice Address - Country:US
Practice Address - Phone:937-276-8321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCK1297OtherRAILROAD MEDICARE
OH0056424Medicaid
OHCK1297OtherRAILROAD MEDICARE