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General NPI Number Information
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NPI Number | 1073977286
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Entity Type | Organization
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Legal Business Name | METRO IMAGING BUFORD
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 04/13/2016
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Provider Practice Location Address
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Address Line | 3425 BUFORD DR SUITE 100
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City | BUFORD
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State | GA
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Zip | 30519-8785
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Country | US
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Telephone | 706-433-4123
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 48267
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City | ATHENS
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State | GA
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Zip | 30604-8267
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | WALTER PRICE
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Credential |
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Telephone | 706-433-4123
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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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