Healthcare Provider Details

I. General information

NPI: 1841125309
Provider Name (Legal Business Name): ASKEIA GARDNER R.T.(R) (CT)
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 SUMMERWOOD LN
STOCKBRIDGE GA
30281-1146
US

IV. Provider business mailing address

240 SUMMERWOOD LN
STOCKBRIDGE GA
30281-1146
US

V. Phone/Fax

Practice location:
  • Phone: 470-246-9278
  • Fax:
Mailing address:
  • Phone: 470-246-9278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number551212
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: