Healthcare Provider Details

I. General information

NPI: 1720227259
Provider Name (Legal Business Name): QUALITY RADIOLOGY GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2009
Last Update Date: 02/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 BOULEVARD NE SUITE 224
ATLANTA GA
30312
US

IV. Provider business mailing address

6382 LAUREL POST COURT
LITHONIA GA
30058
US

V. Phone/Fax

Practice location:
  • Phone: 404-754-1640
  • Fax:
Mailing address:
  • Phone: 404-754-1640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number136391LGB
License Number StateGA

VIII. Authorized Official

Name: RICHARD ANDREW WHITE III
Title or Position: PRESIDENT, CEO
Credential: RT,(R)
Phone: 404-754-1640