NPI age
19 years
Enumerated 2006-06-03
Across 220 active radiology providers in Georgia.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TN) | 4047558 | |
| 01 (GA) | 92BBGBS | MEDICARE PROVIDER ID |
| 05 (GA) | 000959175B | |
| 05 (NC) | 89065TU |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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