Organization
OPEN MRI OF SYLACAUGA, LLC
Active
Other names
Open MRI of Sylacauga
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONNIE MARTIN (DIRECTOR OF BILLING)
(205) 995-9388
Entity
Organization
Contact information
Practice address
395 JAMES PAYTON BLVD, SYLACAUGA, AL 35150-8064
(256) 207-2686
(256) 207-2551
Mailing address
PO BOX 933108, ATLANTA, GA 31193-3108
(205) 995-9899
(205) 995-1255
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023040409
N. MELINDA BERGQUIST, MD
AL
01
—
1124000344
RUTH SNOW, MD
—
01
—
1235111451
CECIL EILAND, MD
—
01
—
1427030642
ROBERT EICHELBERGER, MD
—
01
—
1598747719
THOMAS HARRELL, MD
—
01
—
1659353886
DONALD REYNOLDS, MD
—
01
—
1730146069
MARK CONNELL, MD
—
01
—
1942282173
PAMELA KULBACK, MD
—
01
—
51530056
BCBS - FACILITY PROVIDER ID NUMBER
AL
05
—
529925390
—
AL
01
—
P00206200
RAILROAD MEDICARE
GA
Enumeration date
01/30/2006
Last updated
02/17/2009
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