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General NPI Number Information
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NPI Number | 1265540314
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Entity Type | Organization
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Legal Business Name | STEPHEN W. BROWN AND RADIOLOGY ASSOCIATES OF AUGUSTA LLP
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 05/13/2009
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Provider Practice Location Address
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Address Line | 818 SAINT SEBASTIAN WAY SUITE 100
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City | AUGUSTA
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State | GA
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Zip | 30901-2651
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Country | US
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Telephone | 706-722-3574
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 TROUPE ST
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City | AUGUSTA
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State | GA
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Zip | 30904-4480
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Country | US
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Telephone | 706-737-4575
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Fax | 706-731-5289
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Authorized Official
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Title or Position | MD / PARTNER
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Name | DR. HUEY G BULLOCK
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Credential | MD
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Telephone | 706-737-4575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Radiology) Physician
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License Number | 017192
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 017192
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 017192
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | 017192
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | 017192
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 017192
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 017192
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License Number State | GA
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