Healthcare Provider Details

I. General information

NPI: 1295067361
Provider Name (Legal Business Name): JOSEPH CHEEK RPA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2010
Last Update Date: 02/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2675 N DECATUR RD
DECATUR GA
30033-6131
US

IV. Provider business mailing address

1352 CROOKED TREE CT SW
LILBURN GA
30047-2433
US

V. Phone/Fax

Practice location:
  • Phone: 404-564-5400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code243U00000X
TaxonomyRadiology Practitioner Assistant
License Number03 NC 1067
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: