Healthcare Provider Details

I. General information

NPI: 1922338656
Provider Name (Legal Business Name): ATLANTIC RADIOLOGY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2009
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 MOSS CREEK VILLAGE
HILTON HEAD SC
29925
US

IV. Provider business mailing address

PO BOX 14185
SAVANNAH GA
31416-1185
US

V. Phone/Fax

Practice location:
  • Phone: 843-836-7030
  • Fax: 786-975-2608
Mailing address:
  • Phone: 912-350-8466
  • Fax: 786-975-2608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JEFF KINLAW
Title or Position: CEO
Credential:
Phone: 912-350-8466