Provider Demographics
NPI:1932189685
Name:ATHENS RADIOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:ATHENS RADIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:COLEMAN
Authorized Official - Last Name:WALPERT
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:706-850-5001
Mailing Address - Street 1:PO BOX 106062
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30348-6062
Mailing Address - Country:US
Mailing Address - Phone:706-850-5001
Mailing Address - Fax:706-521-8593
Practice Address - Street 1:1199 PRINCE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606
Practice Address - Country:US
Practice Address - Phone:706-389-3075
Practice Address - Fax:706-389-3076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4673OtherMEDICARE ID TYPE UNSPECIF