Provider Demographics
NPI:1598893471
Name:GREATER ATLANTA RADIATION ONCOLOGY CONSULTANTS, LLC
Entity Type:Organization
Organization Name:GREATER ATLANTA RADIATION ONCOLOGY CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:ECHOLS
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-501-6925
Mailing Address - Street 1:179 WORTHINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-5588
Mailing Address - Country:US
Mailing Address - Phone:404-704-5887
Mailing Address - Fax:678-565-0606
Practice Address - Street 1:2675 N DECATUR RD
Practice Address - Street 2:SUITE G03
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6131
Practice Address - Country:US
Practice Address - Phone:404-501-6925
Practice Address - Fax:404-501-6930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA30 00519OtherUHC
GA7488088OtherAETNA US HEALTHCARE
GA000835788RMedicaid
GA172201200452OtherHUMANA
GAP00231025OtherRR MEDICARE PALMETTO GBA
GA117237OtherPEACHSTATE
GA12557Other1ST MEDICAL NETWORK
GA287785207OtherCHAMPUS
GA36 00519OtherUNITED HEALTHCARE
GA10068321OtherAMERIGROUP
GA782373(EMC)OtherBLUE CROSS BLUE SHIELD
GA=========OtherHUMANA MILITARY HEALTHCAR
GA287785207OtherCHAMPUS
GA=========OtherCOVENTRY
GA30 00519OtherUHC
GA7488088OtherAETNA US HEALTHCARE