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NPI Code Detail

MEDICARE: OPEN MRI OF GEORGIA, INC

MEDICARE: OPEN MRI OF GEORGIA, INC
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
12085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1972735009
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPEN MRI OF GEORGIA, INC
Provider Business Mailing Address
First Line : PO BOX 932391
Second Line :
City : ATLANTA
State : GA
Zip : 31193-2391
Country : US
Telephone Number : 678-393-5600
Fax Number : 770-300-9018
Provider Business Practice Location Address
First Line : 2859 N DECATUR RD
Second Line :
City : DECATUR
State : GA
Zip : 30033-5911
Country : US
Telephone Number : 404-329-0656
Fax Number : 404-329-0207
Authorized Official
Title or Position : C.O.O.
Name : MR. DANIEL J SCHAEFER
Credential :
Telephone Number : 770-300-0101
Provider Enumeration Date : 08/24/2009
Last Update Date : 09/23/2013

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