Organization
RADIOLOGY ASSOC OF SOUTH GA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKIE MERRITT (ACCOUNT MANAGER)
(912) 384-6803
Entity
Organization
Contact information
Practice address
1101 OCILLA RD, DOUGLAS, GA 31533-2207
(912) 384-1900
Mailing address
110 BOWENS MILL RD, DOUGLAS, GA 31533-2250
(912) 384-6803
(912) 383-6365
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300030604A
—
GA
Enumeration date
05/25/2007
Last updated
05/20/2015
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