Provider Demographics
NPI:1043470883
Name:DIGITAL RADIOGRAPHIC DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:DIGITAL RADIOGRAPHIC DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:CARLYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-401-3717
Mailing Address - Street 1:3535 ROSWELL RD
Mailing Address - Street 2:SUITE-1 BUILDING-1
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-8826
Mailing Address - Country:US
Mailing Address - Phone:404-401-3717
Mailing Address - Fax:
Practice Address - Street 1:3535 ROSWELL RD
Practice Address - Street 2:SUITE-1 BUILDING-1
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-8826
Practice Address - Country:US
Practice Address - Phone:404-401-3717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology