Healthcare Provider Details

I. General information

NPI: 1376781914
Provider Name (Legal Business Name): MEGHNA KRISHNAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2009
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 WRIGHTSBORO RD
AUGUSTA GA
30904-6220
US

IV. Provider business mailing address

9300 E RAINTREE DR STE 130
SCOTTSDALE AZ
85260-7313
US

V. Phone/Fax

Practice location:
  • Phone: 706-737-3948
  • Fax:
Mailing address:
  • Phone: 602-878-7501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2010014111
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: