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General NPI Number Information
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NPI Number | 1184650228
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Entity Type | Organization
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Legal Business Name | MARSHALL RADIOLOGY PC
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 06/21/2016
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Provider Practice Location Address
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Address Line | 2505 US HIGHWAY 431
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City | BOAZ
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State | AL
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Zip | 35957-5908
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Country | US
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Telephone | 256-840-3688
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1164
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City | DALTON
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State | GA
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Zip | 30722-1164
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Country | US
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Telephone | 706-271-0100
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Fax | 706-270-0487
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LISA DRISKILL
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Credential | MD
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Telephone | 706-271-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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