Provider Demographics
NPI:1356443683
Name:CAROLINA RADIOLOGICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CAROLINA RADIOLOGICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD / PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:
Authorized Official - Last Name:GAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:803-644-1357
Mailing Address - Street 1:P.O. BOX 3847
Mailing Address - Street 2:1125 TROUPE STREET
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30914-3847
Mailing Address - Country:US
Mailing Address - Phone:706-667-7450
Mailing Address - Fax:706-731-5289
Practice Address - Street 1:302 UNIVERSITY PRKWY.
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29802
Practice Address - Country:US
Practice Address - Phone:706-737-4575
Practice Address - Fax:706-731-5289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
No2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic NeuroimagingGroup - Multi-Specialty
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Multi-Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric RadiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)Group - Multi-Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Multi-Specialty
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, MammographyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
608241300OtherACS DOL
608241301OtherFEDERAL BLACK LUNG
SCGP4161Medicaid
608241301OtherFEDERAL BLACK LUNG
SC8298Medicare PIN