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Organization
THE IMAGING CENTER
Active
Organization
THE IMAGING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUEY G. BULLOCK MD (MD/PARTNER/MEDICAL DIRECTOR)
(706) 737-4575
Entity
Organization
Contact information
Practice address
818 ST. SEBASTIAN WAY, SUITE 100, AUGUSTA, GA 30901
(706) 722-3574
(706) 731-5289
Mailing address
1125 TROUPE ST, AUGUSTA, GA 30904-4480
(706) 737-4575
(706) 731-5289
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
014725
GA
2085U0001X
Diagnostic Ultrasound Physician
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00015804C
—
GA
01
—
1023072147
NPI - JIMPSEY B. JOHNSON
—
01
—
1033173067
NPI - HUEY G. BULLOCK
—
01
—
1418019
UNITED MINE WORKERS
—
01
—
156858201
FEDERAL BLACK LUNG
—
01
—
16-00225
UNITED HEALTHCARE
—
05
—
SL0006
—
SC
Enumeration date
08/29/2006
Last updated
08/19/2009
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