Med Tel International Corporation

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

0446IC Issued in OH

Legal business name

MED TEL INTERNATIONAL CORPORATION

Doing business as

Wide Open Imaging

Practice address

800 Pike St
Marietta, OH 45750-3507

Phone

(740) 374-7500

Fax

(740) 374-8802

NPI assigned

Mar 15, 2007

Organization subpart

Yes

Parent organization

MED TEL INTERNATIONAL CORPORATIONAs reported in NPPES

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

Authorized official

Name

John Valla

Title

Vice President

Phone

(973) 873-9850

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wide Open Imaging Doing business as

Part of

Med-Tel Intrntl Corp

Locations

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1457485054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 SPRING HILL RD",
            "address_2": "SUITE 500",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221023000",
            "telephone_number": "703-287-4189",
            "fax_number": "703-448-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PIKE ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457503507",
            "telephone_number": "740-374-7500",
            "fax_number": "740-374-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED TEL INTERNATIONAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MED TEL INTERNATIONAL CORPORATION",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "VALLA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "973-873-9850"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "OH",
            "license": "0446IC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2653570",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wide Open Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shaun McMillin, DO
• Barbara Lynn McNeil, DC
• Devon Nichole McPherson, CASE MANGER
• Allyson McVicar
• Julie Nicole Meade
• Hanumantharao Medarametla, MD
• Medical Service Company
• Antonio Meehan
• Jana Caroline Meister, OTR/L
• Erick C Meliher, NP

• Radiology Clinic/Center in Marietta, OH
• Providers in Marietta, OH by specialty
• Radiology Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.