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General NPI Number Information
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NPI Number | 1043470883
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Entity Type | Organization
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Legal Business Name | DIGITAL RADIOGRAPHIC DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 01/20/2009
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Provider Practice Location Address
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Address Line | 3535 ROSWELL RD SUITE-1 BUILDING-1
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City | MARIETTA
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State | GA
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Zip | 30062-8826
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Country | US
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Telephone | 404-401-3717
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Fax |
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Provider Business Mailing Address
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Address Line | 3535 ROSWELL RD SUITE-1 BUILDING-1
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City | MARIETTA
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State | GA
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Zip | 30062-8826
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Country | US
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Telephone | 404-401-3717
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. JOHN FRANCIS CARLYLE
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Credential |
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Telephone | 404-401-3717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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