Provider Demographics
NPI:1528526977
Name:RADDOCTOR, PA
Entity type:Organization
Organization Name:RADDOCTOR, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:I
Authorized Official - Last Name:OKOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-920-5200
Mailing Address - Street 1:9203 PINE ISLAND CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2301
Mailing Address - Country:US
Mailing Address - Phone:813-920-5200
Mailing Address - Fax:813-920-5228
Practice Address - Street 1:9203 PINE ISLAND CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2301
Practice Address - Country:US
Practice Address - Phone:813-920-5200
Practice Address - Fax:813-920-5228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty