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General NPI Number Information
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NPI Number | 1710834692
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Entity Type | Organization
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Legal Business Name | PRECISION WAVE IMAGING PLLC
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Dates
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Enumeration Date | 03/11/2026
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 3967 LANE AVE S
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City | JACKSONVILLE
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State | FL
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Zip | 32210-4809
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Country | US
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Telephone | 404-465-4881
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Fax |
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Provider Business Mailing Address
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Address Line | 3967 LANE AVE S
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City | JACKSONVILLE
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State | FL
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Zip | 32210-4809
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Country | US
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Telephone | 404-465-4881
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | THOMAS CARTER
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Credential | RDMS, RVT
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Telephone | 404-465-4881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246X00000X
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Taxonomy Name | Cardiovascular Specialist/Technologist
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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 | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number |
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License Number State |
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