Healthcare Provider Details

I. General information

NPI: 1073575296
Provider Name (Legal Business Name): LOGIC RADIOLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 WATSON BLVD
WARNER ROBINS GA
31093-3431
US

IV. Provider business mailing address

753 JOHNNIE DODDS BLVD
MT PLEASANT SC
29464-3054
US

V. Phone/Fax

Practice location:
  • Phone: 478-542-7765
  • Fax: 478-923-4104
Mailing address:
  • Phone: 843-284-3400
  • Fax: 843-284-3401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number056665
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number052326
License Number StateGA

VIII. Authorized Official

Name: DR. APARNA VELNATI
Title or Position: PRESIDENT
Credential: MD
Phone: 478-542-7765