Southwood Pet Scan, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

SOUTHWOOD PET SCAN, LLC

Practice address

250 Debartolo PL
Building B
Youngstown, OH 44512-7004

Phone

(330) 729-0357

Fax

(330) 729-0358

NPI assigned

Jun 4, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Jo Morris

Title

Enrollment Specialist

Phone

(412) 937-5726

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1467491845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 DEBARTOLO PL",
            "address_2": "BUILDING B",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445127004",
            "telephone_number": "330-729-0357",
            "fax_number": "330-729-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 DEBARTOLO PL",
            "address_2": "BUILDING B",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445127004",
            "telephone_number": "330-729-0357",
            "fax_number": "330-729-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWOOD PET SCAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "MARY JO",
        "authorized_official_title_or_position": "ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "412-937-5726"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Soto
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• Patricia Southerly, D.O.
• Southerncare, Inc. (SouthernCare Youngstown)
• Southside Academy, Inc.
• Southwoods Anesthesia, LLC
• Southwoods Health at Home, LLC
• Southwoods Healthcare Associates,LLC
• Southwoods Rehabiliation LLC (Southwoods Physical Therapy)
• Southwoods Rehabilitation LLC (Southwoods Physical Therapy)

• Diagnostic Radiology Physician in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Diagnostic Radiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.