| NPI | 1063473197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE T BROUGHAN Manager 912-354-7089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: GA 034456) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging |
| 2085N0700X Radiology Neuroradiology | |
| 2085N0904X Radiology Nuclear Radiology | |
| 2085R0202X Radiology Diagnostic Radiology | |
| 2085R0204X Radiology Vascular & Interventional Radiology | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2010-12-29 |