MEDICARE: RADIOLOGY CONSULTANTS PC

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
1	2085R0202X	Diagnostic Radiology Physician		GA

Other Identifiers

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

General Provider Information

NPI Number	:	1942294087
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIOLOGY CONSULTANTS PC

Provider Business Mailing Address
First Line	:	PO BOX 859
Second Line	:
City	:	WAYCROSS
State	:	GA
Zip	:	31502-0859
Country	:	US
Telephone Number	:	912-466-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2415 PARKWOOD DR
Second Line	:
City	:	BRUNSWICK
State	:	GA
Zip	:	31520-4722
Country	:	US
Telephone Number	:	912-466-7000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ADRIANA RODRIGUEZ
Credential	:	MD
Telephone Number	:	912-466-7000

Provider Enumeration Date	:	09/05/2005
Last Update Date	:	07/21/2022

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