Organization
SOUTHERN MOLECULAR IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM C LAVELY M.D. (OWNER)
(912) 856-4032
Entity
Organization
Contact information
Practice address
2001 PROFESSIONAL PKWY, SUITE 160, WOODSTOCK, GA 30188-6444
(912) 856-4032
Mailing address
2001 PROFESSIONAL PKWY, SUITE 160, WOODSTOCK, GA 30188-6444
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
Other
Enumeration date
04/13/2009
Last updated
05/23/2012
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