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General NPI Number Information
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NPI Number | 1710147210
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Entity Type | Organization
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Legal Business Name | PHOEBE RADIOLOGY
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 417 W 3RD AVE
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City | ALBANY
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State | GA
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Zip | 31701-1943
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Country | US
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Telephone | 229-312-5800
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Fax | 229-312-5853
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Provider Business Mailing Address
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Address Line | PO BOX 2548
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City | ALBANY
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State | GA
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Zip | 31702-2548
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Country | US
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Telephone | 229-312-5800
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Fax | 229-312-5853
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Authorized Official
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Title or Position | SENIOR VP
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Name | FRANK M MIDDLETON III
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Credential | MD
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Telephone | 229-312-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number |
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Taxonomy #2
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Taxonomy Code | 2085D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Radiology) Physician
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License Number |
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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 |
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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 |
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Taxonomy #5
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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Taxonomy #6
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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Taxonomy #7
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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Taxonomy #8
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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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