Healthcare Provider Details

I. General information

NPI: 1902882616
Provider Name (Legal Business Name): BARROW RADIOLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 N BROAD ST
WINDER GA
30680-2187
US

IV. Provider business mailing address

PO BOX 1247
COVINGTON GA
30015-1247
US

V. Phone/Fax

Practice location:
  • Phone: 770-682-3564
  • Fax:
Mailing address:
  • Phone: 770-682-3564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateGA

VIII. Authorized Official

Name: STEPHEN G FOX
Title or Position: PRESIDENT
Credential: MD
Phone: 770-682-3564