Provider Demographics
NPI:1912362161
Name:METRO IMAGING SANDY SPRINGS, LLC
Entity Type:Organization
Organization Name:METRO IMAGING SANDY SPRINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTED MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:GRAYSON
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-433-4123
Mailing Address - Street 1:PO BOX 48267
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30604-8267
Mailing Address - Country:US
Mailing Address - Phone:706-433-4123
Mailing Address - Fax:706-354-0529
Practice Address - Street 1:5730 GLENRIDGE DR
Practice Address - Street 2:SUITE T-300
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-6141
Practice Address - Country:US
Practice Address - Phone:470-440-2600
Practice Address - Fax:470-440-2605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-15
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty