Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacksonville Diagnostic Imaging LLC

Organization Diagnostic Radiology Physician · NPI 1104874387

Jacksonville Diagnostic Imaging LLC is a Diagnostic Radiology Physician in Jacksonville, North Carolina. Licensed in North Carolina. Registered with an NPI since 2006.

Licensed in
NC
In the registry since
2006
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3606 Henderson Dr
Jacksonville, NC 28546-5217
Phone: (910) 937-7226
Fax: (910) 937-0064
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X (NC)

Record details

NPI number1104874387
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Geoffrey Gardner — Svp Finance And Revenue Cycle · (336) 718-2078
Other names Coastal Diagnostic Imaging
NPI enumeratedMay 4, 2006
Last updated in NPPESMarch 19, 2024
Certification dateMarch 19, 2024
Mailing addressPo Box 933393, Atlanta, GA 31193-0001

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