# SOUTHERN RADIOLOGY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Raghava A. Bhaskaran, M.D.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235224346
- **Authorized official:** RAGAHAVA A BHASKARAN M.D. (PHYSICIAN)
- **Authorized official phone:** (478) 274-1100

## Contact information

- **Practice address:** 606 ACADEMY AVENUE, DUBLIN, GA 31021
- **Practice address phone:** (478) 274-1100
- **Practice address fax:** (478) 274-1166
- **Mailing address:** P. O. BOX 1527, DUBLIN, GA 31040
- **Mailing address phone:** (478) 274-1100
- **Mailing address fax:** (478) 274-1166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085B0100X | Body Imaging Physician | 025580 | GA | — |
| 2085R0202X | Diagnostic Radiology Physician | 025580 | GA | — |
| 2085U0001X | Diagnostic Ultrasound Physician | 025580 | GA | — |
| 208D00000X | General Practice Physician | 025580 | GA | Yes |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 06/21/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000321417E | — | GA |
| 01 | — | 297149 | WELLCARE | GA |