NPI age
19 years
Enumerated 2006-07-12
● Active
Type 1 · Individual
Song-Chu Ko, M.D.
Ko is 1 of 6 radiology providers in MacOn and 1 of 220 in Georgia.
Primary specialty
Radiology
Plus 3 subspecialties
Licensed in
GA, IN, GU, AL
4 states
Status
Active
No deactivations on record
Last NPPES update
2025-06-30
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 220 active radiology providers in Georgia.
NPI age
19 years
≈ at median (19 yr)
State licenses
4 states
Top 74% — 25% of peers are multi-state
Subspecialties
0
42% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-07Enumerated in NPPES
2006
2026
Where they practice
Practice location
308 Coliseum Dr Ste 100
MacOn, GA 312173889
Mailing address
308 Coliseum Dr Ste 100
MacOn, GA 312173889
Additional practice locations
1 secondary location on file with NPPES.
Location 2
2501 Village Professional Dr
Opelika, AL 368012381
Specialties
-
Radiology PrimaryA radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (IN) | 000000711556 | ANTHEM PROVIDER NUMBER |
| 05 (IN) | 200826200 |
Multi-state credentialing: Licensed in 4 states. Useful context for credentialers building cross-state provider networks.
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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