Unknown Individual – Diagnostic Radiology Physician, NPI 1073508107
Diagnostic Radiology Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
PO BOX 2049
MOULTRIE, GA 317762049
Phone: (229) 985-8802
Fax: (229) 891-2016
Type: Mailing
1703, Meadows Lane, Vidalia, Toombs County, Georgia, 30474, United States
VIDALIA, GA 304748915
Phone: (229) 985-8802
Fax: (229) 891-2016
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 31776)
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