Provider Demographics
NPI:1528043718
Name:RADIOLOGY ASSOCIATES OF ATLANTA, PA
Entity Type:Organization
Organization Name:RADIOLOGY ASSOCIATES OF ATLANTA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:HALPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-352-1409
Mailing Address - Street 1:1984 PEACHTREE RD NW
Mailing Address - Street 2:SUITE 505
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-5219
Mailing Address - Country:US
Mailing Address - Phone:404-352-1409
Mailing Address - Fax:404-352-8176
Practice Address - Street 1:1968 PEACHTREE RD NW
Practice Address - Street 2:ATTN: RADIOLOGY DEPT
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1281
Practice Address - Country:US
Practice Address - Phone:404-352-1409
Practice Address - Fax:404-352-8176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-09
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========DMedicare PIN