Organization · Type 2 NPI

Mountain States Health Alliance

Diagnostic Radiology Physician · Lebanon, VA

NPI number 1104158054 Active

Practice location

58 Carroll St
Lebanon, VA 24266-3600

Call (276) 883-8101 Map

Fax (276) 889-4336

Mailing address

PO Box 3600
Lebanon, VA 24266-0200

Specialties and licenses

TaxonomyCodeLicense
Diagnostic Radiology Physician Primary 2085R0202XNone listed

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

11 other providers at this address

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About NPI 1104158054

Mountain States Health Alliance's National Provider Identifier is 1104158054, issued on Feb 3, 2010. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Lebanon, VA. The record was last updated on Apr 16, 2026.