Organization
CHILDREN'S DIAGNOSTIC IMAGING OF ATLANTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BROYLES (CREDENTIALING)
(770) 779-2168
Entity
Organization
Contact information
Practice address
1001 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1605
(404) 785-2162
Mailing address
PO BOX 2936, KENNESAW, GA 30156-9116
(770) 779-0010
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
—
—
Other
Enumeration date
05/17/2006
Last updated
08/22/2020
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