Organization
OSSP IMAGING OF MACON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RA'KESHIA BROGDON (CREDENTIALING SPECIALIST)
(678) 783-7619
Entity
Organization
Contact information
Practice address
4601 ARKWRIGHT RD, MACON, GA 31210-1303
(478) 217-2212
(770) 679-8647
Mailing address
5788 ROSWELL RD, ATLANTA, GA 30328-4904
(305) 290-2448
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
03/29/2021
Last updated
03/29/2021
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