Organization
SOUTH ALABAMA DIAGNOSTIC IMAGING, P.C.
Active
Organization
SOUTH ALABAMA DIAGNOSTIC IMAGING, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN C TOMBERLIN M.D. (OWNER)
(334) 684-7156
Entity
Organization
Contact information
Practice address
1200 W MAPLE AVE, GENEVA, AL 36340-1642
(334) 684-7156
(334) 684-7709
Mailing address
PO BOX 1928, BAINBRIDGE, GA 39818-1928
(334) 684-3655
(334) 684-3312
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
10925
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000085322
—
AL
01
—
047944600
FLORIDIA MEDICAID
FL
Enumeration date
12/14/2006
Last updated
06/14/2019
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