| NPI | 1831370188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH A MADDOX Billing 706-745-8790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QR0200X Clinic/Center Radiology |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2025-03-12 |