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General NPI Number Information
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NPI Number | 1790113082
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Entity Type | Organization
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Legal Business Name | AMERICAN HEALTH IMAGING OF GEORGIA LLC
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Dates
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Enumeration Date | 10/23/2013
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 3152 PERIMETER PKWY UNIT B
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City | AUGUSTA
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State | GA
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Zip | 30909-4583
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Country | US
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Telephone | 706-364-2603
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Fax | 706-364-2606
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Provider Business Mailing Address
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Address Line | PO BOX 745973
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City | ATLANTA
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State | GA
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Zip | 30374-5973
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Country | US
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Telephone | 404-296-5887
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Fax | 404-296-3129
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Authorized Official
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Title or Position | DIRECTOR OF CREDENTIALING
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Name | KATRINA ROELLE
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Credential |
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Telephone | 614-689-1691
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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 | LCB20060033745
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License Number State | GA
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