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General NPI Number Information
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NPI Number | 1184656936
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Entity Type | Organization
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Legal Business Name | ATLANTIC RADIOLOGY ASSOCIATES PA
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | 2808 MCLAMB PL
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City | GOLDSBORO
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State | NC
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Zip | 27534-1600
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Country | US
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Telephone | 919-759-0654
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 198849
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City | ATLANTA
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State | GA
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Zip | 30384-8849
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Country | US
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Telephone | 910-395-9984
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Fax | 866-504-4009
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEORGE W EASON
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Credential | MD
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Telephone | 910-395-9984
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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 | 20123
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License Number State | NC
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