National Provider Identifier Database

DALTON OUTPATIENT CENTER DAL DIAGNOSTIC ASSOC LP
Radiology


Contact Information

DALTON OUTPATIENT CENTER DAL DIAGNOSTIC ASSOC LP
1502 NORTH THORNTON AVE
DALTON, GA30720
Phone: 706-278-9729
Fax: 706-226-9378
Website:
Specialty Taxonomy Code
* Radiology 261QR0200X

* Indicates primary specialty

NPI Profile & details for DALTON OUTPATIENT CENTER DAL DIAGNOSTIC ASSOC LP

NPI Number 1588750947
Legal business name
LBN
DALTON OUTPATIENT CENTER DAL DIAGNOSTIC ASSOC LP
Authorized official JOHN CHURCH - (RADIOLOGIST GENERAL PARTNER)
Entity Organization
Organization subpart No
Enumeration date 10/05/2006
Last updated 08/01/2007 - About 19 years ago
Sole proprietor1 Not specified
Identifiers
  • GA Medicaid: 00248245F
  • GA Other: CM5117 RAILROAD MEDICARE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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