1932189685 NPI number — ATHENS RADIOLOGY ASSOCIATES PC

Table of content: (NPI 1932189685)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932189685 NPI number — ATHENS RADIOLOGY ASSOCIATES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATHENS RADIOLOGY ASSOCIATES PC
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:
1932189685
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 106062
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30348-6062
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-264-3435
Provider Business Mailing Address Fax Number:
843-497-9566

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
245 FLOYD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATHENS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30607-1469
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
762-356-4780
Provider Business Practice Location Address Fax Number:
843-497-9566
Provider Enumeration Date:
01/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WALPERT
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
COLEMAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
706-850-5001

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: CA4673 . This is a "MEDICARE ID TYPE UNSPECIF" identifier . This identifiers is of the category "OTHER".




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