| NPI | 1265540314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUEY G BULLOCK Md / Partner 706-737-4575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: GA 017192) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: GA 017192) |
| 2085D0003X Radiology Diagnostic Neuroimaging (Licence: GA 017192) | |
| 2085N0700X Radiology Neuroradiology (Licence: GA 017192) | |
| 2085N0904X Radiology Nuclear Radiology (Licence: GA 017192) | |
| 2085P0229X Radiology Pediatric Radiology (Licence: GA 017192) | |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: GA 017192) | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2009-05-13 |