NPIMap

Organization Active NPI

Vascular and Interventional Radiology Clinic of Jackson

  • Radiology Clinic/Center
  • Jackson, TN
National Provider Identifier
1043470933
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
VASCULAR AND INTERVENTIONAL RADIOLOGY CLINIC OF JACKSON
Practice address
300 Coatsland Dr
Jackson, TN 38301-3908
Phone
(731) 541-8854
NPI assigned
Jun 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Matthew T Graham, MD
Title
President
Phone
(731) 541-6174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

300 Coatsland Dr
Jackson, TN 38301-3908

Mailing address

PO Box 3614
Jackson, TN 38303-3614
Phone (731) 541-8854

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1043470933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3614",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383033614",
            "telephone_number": "731-541-8854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COATSLAND DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013908",
            "telephone_number": "731-541-8854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR AND INTERVENTIONAL RADIOLOGY CLINIC OF JACKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-13",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "731-541-6174",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.