Healthcare Provider Details

I. General information

NPI: 1871962829
Provider Name (Legal Business Name): MOBILE MEDICAL DIAGNOSTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2015
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 EDGEWOOD CIR STE 9
COLUMBUS GA
31907-1892
US

IV. Provider business mailing address

2121 LOHMANS CROSSING RD STE 504
LAKEWAY TX
78734-5288
US

V. Phone/Fax

Practice location:
  • Phone: 866-218-3754
  • Fax: 512-852-4482
Mailing address:
  • Phone: 866-218-3754
  • Fax: 512-852-4482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRIDGET DUNBAR
Title or Position: COO
Credential:
Phone: 512-673-7552