1922193044 NPI number — NORTH GEORGIA RADIOLOGY

Table of content: DR. JASON DAVID WRIGHT D.O. (NPI 1942438841)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922193044 NPI number — NORTH GEORGIA RADIOLOGY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH GEORGIA RADIOLOGY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922193044
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/14/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2546
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALTON
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30722-2546
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-271-0100
Provider Business Mailing Address Fax Number:
706-270-0487

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1407 N THORNTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALTON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30720-3093
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-259-4428
Provider Business Practice Location Address Fax Number:
706-226-2283
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MORRISON
Authorized Official First Name:
RACHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING
Authorized Official Telephone Number:
423-310-1642

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000315774B , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: CB4606 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




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