Maxim Diagnostic Center, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

MAXIM DIAGNOSTIC CENTER, LLC

Practice address

2618 E Bankhead Hwy
Weatherford, TX 76087-9558

Phone

(817) 341-3016

Fax

(817) 341-2394

NPI assigned

Nov 16, 2005

Organization subpart

No

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

Authorized official

Name

Mr. William Macknight

Title

Managing Partner

Phone

(817) 341-3016

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972585818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2618 E BANKHEAD HWY",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760879558",
            "telephone_number": "817-341-3016",
            "fax_number": "817-341-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2618 E BANKHEAD HWY",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760879558",
            "telephone_number": "817-341-3016",
            "fax_number": "817-341-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIM DIAGNOSTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACKNIGHT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "817-341-3016",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Radiology Clinic/Center in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Radiology Clinic/Center in Texas

• 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.