NPI age
19 years
Enumerated 2007-03-14
Across 220 active radiology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (MO) | P00817807 | RAILROAD MEDICARE-CB9013 |
| 05 (MO) | 1407989742 | |
| 01 | 431560263 | TRICARE WEST |
| 05 (AR) | 176697001 |
Part of a multi-provider practice. 11 other active providers share this practice address in NPPES.
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