Organization
P E T IMAGING OF FAYETTE LLC
Active
Parent organization
TRIDENT MOLECULAR IMAGING, LLC
Other names
Trident PET of Fayette
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRIDENT MOLECULAR IMAGING, LLC
Authorized official
GUY A MESSER (CFO)
(770) 692-2371
Entity
Organization
Contact information
Practice address
1275 HIGHWAY 54 W, STE 102, FAYETTEVILLE, GA 30214-4549
(770) 719-3754
(770) 719-3804
Mailing address
1275 HIGHWAY 54 W, STE 103, FAYETTEVILLE, GA 30214-4549
(770) 692-2371
(770) 692-2373
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
09/16/2005
Last updated
04/10/2012
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