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NPI Code Detail

MEDICARE: UPSTATE RADIOLOGY ASSOCIATES

MEDICARE: UPSTATE RADIOLOGY ASSOCIATES
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 PhysicianSC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932165065
Entity Type Code : Organization
Provider Name (Legal Business Name) : UPSTATE RADIOLOGY ASSOCIATES
Provider Business Mailing Address
First Line : PO BOX 138
Second Line :
City : COLUMBUS
State : GA
Zip : 31902-0138
Country : US
Telephone Number : 800-841-4236
Fax Number :
Provider Business Practice Location Address
First Line : 1 SAINT FRANCIS DR
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-3955
Country : US
Telephone Number : 864-255-1043
Fax Number : 864-560-6757
Authorized Official
Title or Position : PRESIDENT
Name : DR. FORREST P RYAN
Credential : MD
Telephone Number : 864-560-6225
Provider Enumeration Date : 04/26/2006
Last Update Date : 07/21/2022

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Directions to “UPSTATE RADIOLOGY ASSOCIATES ” Practice Location

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