Organization
MED CROSS IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI ROTUNDO (OFFICE MANAGER)
(478) 374-4305
Entity
Organization
Contact information
Practice address
842 PROFESSIONAL CENTER DR, EASTMAN, GA 31023-6734
(478) 374-4305
(478) 374-1366
Mailing address
842 PROFESSIONAL CENTER DR, EASTMAN, GA 31023-6734
(478) 374-4305
(478) 374-1366
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
049913
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00184214A
—
GA
05
—
00909466B
—
GA
01
—
GRP 1184
MEDICARE GROUP #
GA
Enumeration date
05/24/2006
Last updated
12/31/2014
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