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General NPI Number Information
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NPI Number | 1477586568
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Entity Type | Organization
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Legal Business Name | DUNWOODY IMAGING, LLC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 06/18/2012
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Provider Practice Location Address
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Address Line | 1750 OLD SPRING HOUSE LN SUITE 205
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City | ATLANTA
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State | GA
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Zip | 30338-6214
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Country | US
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Telephone | 770-451-4040
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Fax | 770-451-3003
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Provider Business Mailing Address
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Address Line | 1750 OLD SPRING HOUSE LN SUITE 205
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City | ATLANTA
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State | GA
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Zip | 30338-6214
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Country | US
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Telephone | 770-451-4040
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Fax | 770-451-3003
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | ANTHONY KENT GORDON
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Credential | MD
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Telephone | 770-451-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471M1202X
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Taxonomy Name | Magnetic Resonance Imaging Radiologic Technologist
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License Number | 031432
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License Number State | GA
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