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General NPI Number Information
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NPI Number | 1578577110
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Entity Type | Organization
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Legal Business Name | DIAGNOSTICS IMAGING SERVICES, LC
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 07/29/2013
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Provider Practice Location Address
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Address Line | 1100 LAKE HEARN DR NE SUITE 150
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City | ATLANTA
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State | GA
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Zip | 30342-1523
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Country | US
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Telephone | 404-255-5512
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Fax | 404-255-0177
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Provider Business Mailing Address
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Address Line | P.O. BOX 421548
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City | ATLANTA
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State | GA
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Zip | 30342
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Country | US
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Telephone | 404-255-5512
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Fax | 404-255-0177
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. SYRITA THOMPSON
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Credential |
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Telephone | 678-802-1464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | BL02-04073
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License Number State | GA
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