Organization
STEPHEN W. BROWN AND RADIOLOGY ASSOCIATES OF AUGUSTA LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUEY G BULLOCK MD (MD / PARTNER)
(706) 737-4575
Entity
Organization
Contact information
Practice address
818 SAINT SEBASTIAN WAY, SUITE 100, AUGUSTA, GA 30901-2651
(706) 722-3574
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
017192
GA
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
017192
GA
2085N0700X
Neuroradiology Physician
017192
GA
2085N0904X
Nuclear Radiology Physician
017192
GA
2085P0229X
Pediatric Radiology Physician
017192
GA
2085R0202X
Diagnostic Radiology Physician
Primary
017192
GA
2085U0001X
Diagnostic Ultrasound Physician
017192
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1379942
UNITED MINE WORKERS
—
01
—
299670
FEDERAL BLACK LUNG - DOL
—
05
—
GPA516
—
SC
Enumeration date
08/28/2006
Last updated
05/13/2009
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