Healthcare Provider Details

I. General information

NPI: 1467780379
Provider Name (Legal Business Name): ONYX IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2009
Last Update Date: 12/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 ROCK QUARRY RD SUITE 101
STOCKBRIDGE GA
30281-5029
US

IV. Provider business mailing address

1365 ROCK QUARRY RD STE. 101
STOCKBRIDGE GA
30281-5029
US

V. Phone/Fax

Practice location:
  • Phone: 404-943-9996
  • Fax: 404-943-9975
Mailing address:
  • Phone: 404-943-9996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK SCHWAIGER
Title or Position: OWNER
Credential:
Phone: 404-943-9996