Provider Demographics
NPI:1144504184
Name:DLOUHY, JAMES DANIEL (RT(R), (VI))
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DANIEL
Last Name:DLOUHY
Suffix:
Gender:M
Credentials:RT(R), (VI)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:742 12TH ST NE
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-2315
Mailing Address - Country:US
Mailing Address - Phone:641-423-2357
Mailing Address - Fax:
Practice Address - Street 1:1601 BRENNER AVENUE
Practice Address - Street 2:SALISBURY VA MEDICAL CENTER
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144
Practice Address - Country:US
Practice Address - Phone:704-638-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA036452471V0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0106XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular-Interventional Technology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA03645OtherRADIOLOGIC TECHNOLOGIST PERMIT TO PRACTICE