Provider Demographics
NPI:1720227259
Name:QUALITY RADIOLOGY GROUP, INC.
Entity Type:Organization
Organization Name:QUALITY RADIOLOGY GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:III
Authorized Official - Credentials:RT,(R)
Authorized Official - Phone:404-754-1640
Mailing Address - Street 1:6382 LAUREL POST COURT
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058
Mailing Address - Country:US
Mailing Address - Phone:404-754-1640
Mailing Address - Fax:
Practice Address - Street 1:315 BOULEVARD NE
Practice Address - Street 2:SUITE 224
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312
Practice Address - Country:US
Practice Address - Phone:404-754-1640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA136391LGB261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile