Healthcare Provider Details
I. General information
NPI: 1508780503
Provider Name (Legal Business Name): ANANRA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1215 MEMORIAL DR
DALTON GA
30720-2530
US
IV. Provider business mailing address
1841 CHONDRA DR
MARIETTA GA
30062-2736
US
V. Phone/Fax
- Phone: 706-272-6060
- Fax:
- Phone: 404-480-8000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ARIF
ALI
Title or Position: MANAGER
Credential: MD
Phone: 404-480-8000