Organization
RIVERSTONE IMAGING CENTER
Active
Other names
RiverStoneMD, PC
Organization subpart
No
Provider details
NPI number
Authorized official
JODY DAVIS CFO (CHIEF FINANCIAL OFFICER)
(706) 258-4133
Entity
Organization
Contact information
Practice address
101 RIVERSTONE VIS, BLUE RIDGE, GA 30513-6648
(706) 258-4120
Mailing address
101 RIVERSTONE VIS, BLUE RIDGE, GA 30513-6648
(706) 258-4120
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
NOT REQUIRED
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085001714G
—
GA
Enumeration date
11/29/2006
Last updated
08/31/2010
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