Organization
OSSP IMAGING OF AUGUSTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RA'KESHIA BROGDON (CREDENTIALING 'SPECIALIST)
(678) 783-7619
Entity
Organization
Contact information
Practice address
1306 TROUPE ST, AUGUSTA, GA 30904-4799
(706) 842-4113
Mailing address
5788 ROSWELL RD, ATLANTA, GA 30328-4904
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
01/23/2019
Last updated
03/29/2021
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