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General NPI Number Information
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NPI Number | 1487285193
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Entity Type | Organization
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Legal Business Name | AU HEALTH IMAGING, LLC
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Dates
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Enumeration Date | 01/31/2020
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 3722 WHEELER RD
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City | AUGUSTA
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State | GA
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Zip | 30909-6638
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Country | US
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Telephone | 706-721-8623
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Fax | 706-721-1439
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Provider Business Mailing Address
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Address Line | 1120 15TH ST # BI1056
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City | AUGUSTA
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State | GA
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Zip | 30912-0004
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Country | US
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Telephone | 706-721-3813
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Fax | 706-721-9286
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | AMY STOUT
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Credential |
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Telephone | 615-261-2306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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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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