GASTON RADIOLOGY PA NPI 1356324487

NPI Information

NPI: 1356324487
Provider Name: GASTON RADIOLOGY PA
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
620 SUMMIT CROSSING PL
STE 106
GASTONIA, NC
ZIP 28054
Phone: (704) 867-8021
Get Directions

GASTON RADIOLOGY PA is a diagnostic radiology radiology in Gastonia, NC. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. GASTON RADIOLOGY PA NPI is 1356324487. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

620 SUMMIT CROSSING PL
STE 106
GASTONIA, NC
ZIP 28054-176
Phone: (704) 867-8021
Fax: (704) 864-4606

The provider's authorized official is Eric Jax .
The authorized official title is Chief Operating Officer and has the following contact phone number (651) 592-8186.

The enumeration date for this NPI number is 11/22/2005 and was last updated on 5/9/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0067971	OTHER		AETNA HMO
2	8381530	OTHER		AETNA PPO
3	E01618	MEDICAID	SOUTH CAROLINA
4	01618	OTHER		BLUE CROSS BLUE SHIELD NC
5	1702	OTHER		PARTNERS
6	8901618	MEDICAID	NORTH CAROLINA
7	CC8346	OTHER		RAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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