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NPI Code Detail

MEDICARE: TELEMAMMOGRAPHY SPECIALISTS LLC

MEDICARE: TELEMAMMOGRAPHY SPECIALISTS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1598102535
Entity Type Code : Organization
Provider Name (Legal Business Name) : TELEMAMMOGRAPHY SPECIALISTS LLC
Provider Business Mailing Address
First Line : 125 E TRINITY PL
Second Line : SUITE 201
City : DECATUR
State : GA
Zip : 30030-3360
Country : US
Telephone Number : 404-687-8649
Fax Number : 404-687-8945
Provider Business Practice Location Address
First Line : 125 E TRINITY PL
Second Line : SUITE 201
City : DECATUR
State : GA
Zip : 30030-3360
Country : US
Telephone Number : 404-687-8649
Fax Number : 404-687-8945
Authorized Official
Title or Position : PHYSICIAN/ OWNER
Name : DR. MARTHA GARRISON
Credential : MD
Telephone Number : 404-687-8649
Provider Enumeration Date : 05/31/2013
Last Update Date : 05/31/2013

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Directions to “TELEMAMMOGRAPHY SPECIALISTS LLC ” Practice Location

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