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Organization

SOUTHEAST GEORGIA RADIOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DONALD H MANNING M.D. (PRESIDENT)
(912) 466-6170
Entity
Organization

Contact information

Practice address
2000 DAN PROCTOR DR, ST MARYS, GA 31520
(912) 466-6170
Mailing address
3020 SHRINE RD, BRUNSWICK, GA 31520
(912) 267-0533
(912) 267-7313

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
011416
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04155
BCBS GA
GA
05
343124
GA
Enumeration date
05/03/2007
Last updated
04/20/2008
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