Individual
JOE MAXWELL HULSEY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 N BROAD ST NE, ROME, GA 30161-5207
(706) 291-2077
(706) 235-4177
Mailing address
PO BOX 369, ROME, GA 30162-0369
(706) 291-2077
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
028173
GA
2085N0700X
Neuroradiology Physician
028173
GA
2085N0904X
Nuclear Radiology Physician
028173
GA
2085P0229X
Pediatric Radiology Physician
028173
GA
2085R0202X
Diagnostic Radiology Physician
Primary
028173
GA
2085R0203X
Therapeutic Radiology Physician
028173
GA
2085R0204X
Vascular & Interventional Radiology Physician
028173
GA
2085U0001X
Diagnostic Ultrasound Physician
028173
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000477331G
—
GA
01
—
253955
BCBS OF GEORGIA
GA
01
—
300119990
RAILROAD MEDICARE
GA
Enumeration date
11/13/2006
Last updated
07/25/2012
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