Organization
SOUTH GEORGIA RADIOLOGY CONSULTANTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL R. MILLNER MD (MD OWNER)
(706) 737-4575
Entity
Organization
Contact information
Practice address
5843 DEOSTA DR, LAKE PARK, GA 31636-3405
(229) 259-4888
(229) 559-8178
Mailing address
P.O. BOX 3201, 1125 TROUPE STREET, AUGUSTA, GA 30914-3201
(706) 737-4575
(706) 731-5289
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
GA
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447200399
NPI - MICHAEL MILLNER, MD
—
01
—
157743000
ACS DOL
—
Enumeration date
08/29/2006
Last updated
06/22/2009
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