Provider Demographics
NPI:1447299425
Name:DIAGNOSTIC IMAGING ASSOCIATES
Entity type:Organization
Organization Name:DIAGNOSTIC IMAGING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-761-9190
Mailing Address - Street 1:PO BOX 272022
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80227-9022
Mailing Address - Country:US
Mailing Address - Phone:303-761-9190
Mailing Address - Fax:303-761-6322
Practice Address - Street 1:10700 E GEDDES AVE
Practice Address - Street 2:#200
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-3800
Practice Address - Country:US
Practice Address - Phone:303-761-9190
Practice Address - Fax:303-761-6322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
18062OtherPRES SALUD MEDICAID DIA
CO4934048Medicaid
8162030OtherAETNA DIA
CC8410OtherRR MEDICARE DIA
DIW5008OtherBCBS DIA
8162030OtherAETNA DIA
CC8410OtherRR MEDICARE DIA
DIW5008OtherBCBS DIA
COCW5008Medicare PIN