| NPI | 1568894087 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JULIE DEASON Director 706-774-8326 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology | 
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology | 
| 2086S0129X | |
| Enumeration Date | 2013-08-07 | 
| Last Update Date | 2018-02-26 |