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Organization

VIDALIA RADIOLOGY ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TOSAPORN KRASAEATH MD (PRESIDENT)
(800) 382-4023
Entity
Organization

Contact information

Practice address
1703 MEADOWS LN, VIDALIA, GA 30474-8915
(800) 382-4023
Mailing address
PO BOX 2049, MOULTRIE, GA 31776-2049
(800) 382-4023

Taxonomy

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

Other

Enumeration date
11/14/2005
Last updated
07/21/2022
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