Provider Demographics
NPI:1578536686
Name:DCA DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:DCA DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FINKELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-388-2040
Mailing Address - Street 1:880 CRESTMARK DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-2646
Mailing Address - Country:US
Mailing Address - Phone:678-388-2040
Mailing Address - Fax:678-388-2031
Practice Address - Street 1:880 CRESTMARK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-2646
Practice Address - Country:US
Practice Address - Phone:678-388-2040
Practice Address - Fax:678-388-2031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048324261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
11C0001273Medicare ID - Type Unspecified