Twin Falls Imaging & Diagnostic Center LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

TWIN FALLS IMAGING & DIAGNOSTIC CENTER LLC

Practice address

1330 Filer Ave E
Twin Falls, ID 83301-4119

Phone

(208) 732-1205

Fax

(208) 736-2413

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Frederick L Surbaugh, MD

Title

Owner

Phone

(208) 732-1205

Specialties & licenses 1

Addresses

Tax ID family

Twin Falls Imaging and Diagnostic Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Twin Falls Imaging and Diagnostic Center

  • Radiology Clinic/Center
  • Twin Falls, ID
  • NPI 1669483509
  NPD tax ID

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063540136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 SHOUP AVE W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015029",
            "telephone_number": "208-732-1205",
            "fax_number": "208-736-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 FILER AVE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014119",
            "telephone_number": "208-732-1205",
            "fax_number": "208-736-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN FALLS IMAGING & DIAGNOSTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SURBAUGH",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-732-1205",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Twin Falls Chardonnay LLC
• Twin Falls County
• Twin Falls Dental Group PLLC
• Twin Falls Dental PLLC
• Twin Falls Dermatology & Aesthetics
• Twin Falls Imaging & Diagnostic Center LLC
• Twin Falls Imaging and Diagnostic Center
• Twin Falls Internal Medicine PLLC
• Twin Falls Kids Dental LLC
• Twin Falls of Cascadia, LLC

• Clinic/Center in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.