Ivy Gilmore
Radiologic Technologist, Magnetic Resonance Imaging in Decatur, GA. Individual provider (NPI-1).
NPI number1295683845
StatusActive
Last updated in NPPESMar 19, 2026
Details
- NPI
- 1295683845
- Entity type
- Individual (NPI-1)
- Name
- Ivy Gilmore
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 19, 2026
- Certification date
- Mar 13, 2026
- Last updated
- Mar 19, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2471M1202X | Radiologic Technologist, Magnetic Resonance Imaging | 322854 | GA | Yes |
| 2471C3401X | Radiologic Technologist, Computed Tomography | 322854 | GA |
Practice location
1670 Clairmont RdDecatur, GA 30033-4004
Phone 770-567-7500
Mailing address
122 Katy Lake RdJackson, GA 30233-3396
Phone 248-331-6813
Other practice locations
9528 Highway 19
Zebulon, GA 30295-3189
Zebulon, GA 30295-3189
Phone 770-567-7500
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