| NPI | 1962510958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUEY G. BULLOCK Md/Partner/Medical Director 706-737-4575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 014725) |
| 2085D0003X Radiology, Diagnostic Neuroimaging | |
| 2085B0100X Radiology, Body Imaging | |
| 2085N0700X Radiology, Neuroradiology | |
| 2085N0904X Radiology, Nuclear Radiology | |
| 2085P0229X Radiology, Pediatric Radiology | |
| 2085U0001X Radiology, Diagnostic Ultrasound | |
| 261QR0206X Clinic/Center, Radiology, Mammography | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2009-08-19 |