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Organization

MIDDLE GEORGIA RADIOLOGY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER F PARKER (MANAGER)
(478) 275-0580
Entity
Organization

Contact information

Practice address
2406 BELLEVUE RD, ERIN OFFICE PARK, BLDG 12, DUBLIN, GA 31021-2842
(478) 275-0580
(478) 272-0538
Mailing address
PO BOX 1013, DUBLIN, GA 31040-1013
(478) 275-0580
(478) 272-0538

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
H106498
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
H106498
CORPORATE LICENSE NUMBER
GA
Enumeration date
05/11/2006
Last updated
08/22/2020
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