Central Georgia Mri LLC
Radiology, Diagnostic Radiology in Macon, GA. Organization (NPI-2).
NPI number1114908522
StatusActive
Last updated in NPPESNov 6, 2012
Details
- NPI
- 1114908522
- Entity type
- Organization (NPI-2)
- Legal business name
- Central Georgia Mri LLC
- Organization subpart
- No
- Enumeration date
- Nov 11, 2005
- Last updated
- Nov 6, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | – | – | Yes |
Practice location
770 Pine St Ste L15Attn: Radiology Department
Macon, GA 31201-7519
Phone 478-746-1020 · Fax 478-746-0591
Mailing address
770 Pine St Ste L15Attn: Radiology Department
Macon, GA 31201-7519
Phone 478-746-1020 · Fax 478-746-0591
Authorized official
Mark E. Grossnickle
President
4787461020
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