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General NPI Number Information
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NPI Number | 1073698866
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Entity Type | Individual
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Provider Name | JULIO MARIO ARAQUE MD
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Gender | Male
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 1120 15TH ST DEPARTMENT OF RADIOLOGY
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City | AUGUSTA
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State | GA
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Zip | 30912-0004
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Country | US
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Telephone | 706-721-3670
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Fax |
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Provider Business Mailing Address
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Address Line | 1499 WALTON WAY STE 1400 ATTN: SABRINA THOMAS
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City | AUGUSTA
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State | GA
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Zip | 30901-2603
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Country | US
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Telephone | 706-828-6410
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Fax | 706-722-7235
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 058437
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | 058437
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License Number State | GA
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