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General NPI Number Information
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NPI Number | 1811683345
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Entity Type | Organization
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Legal Business Name | WOMEN'S IMAGING SPECIALISTS - MACON, LLC
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Dates
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Enumeration Date | 04/17/2023
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 718 1ST ST
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City | MACON
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State | GA
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Zip | 31201-6840
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Country | US
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Telephone | 866-300-8512
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Fax | 800-889-0010
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Provider Business Mailing Address
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Address Line | 3180 N POINT PKWY STE 106
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City | ALPHARETTA
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State | GA
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Zip | 30005-4349
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Country | US
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Telephone | 866-300-8512
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Fax | 800-613-8386
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER REDDY
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Credential |
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Telephone | 866-300-8512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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