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NPI Code Detail

MEDICARE: DCA DIAGNOSTICS, LLC

MEDICARE: DCA DIAGNOSTICS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0800XEndoscopy Clinic/Center
2261QA1903XAmbulatory Surgical Clinic/Center048324GA

General Provider Information

NPI Number : 1578536686
Entity Type Code : Organization
Provider Name (Legal Business Name) : DCA DIAGNOSTICS, LLC
Provider Business Mailing Address
First Line : 880 CRESTMARK DR STE 102
Second Line :
City : LITHIA SPRINGS
State : GA
Zip : 30122-2646
Country : US
Telephone Number : 678-741-2317
Fax Number : 770-944-4522
Provider Business Practice Location Address
First Line : 880 CRESTMARK DR
Second Line : SUITE 102
City : LITHIA SPRINGS
State : GA
Zip : 30122-2646
Country : US
Telephone Number : 678-388-2040
Fax Number : 678-388-2031
Authorized Official
Title or Position : PRACTICE ADMINISTRATION
Name : TRACY L JONES
Credential :
Telephone Number : 678-741-2317
Provider Enumeration Date : 02/09/2006
Last Update Date : 12/03/2025

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Directions to “DCA DIAGNOSTICS, LLC ” Practice Location

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