DALTON OUTPATIENT CENTER DAL DIAGNOSTIC ASSOC LP (NPI# 1588750947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588750947 |
Entity Type | Organization |
Organization Name | DALTON OUTPATIENT CENTER DAL DIAGNOSTIC ASSOC LP |
Other Organization Name | DALTON IMAGING CENTER |
Practice Address |
1502 North Thornton Ave Dalton GA 30720 |
Mailing Address |
Po Box 1207 Dalton GA 30722-1207 |
Practice Telephone | 7062789729 |
Practice Fax Number | 7062269378 |
Mailing Telephone | 7062789729 |
Mailing Fax Number | 7062269378 |
Enumeration Date | 2006-10-05 |
Last Update Date | 2007-08-01 |
Authorized Official Name | MR. JOHN CLAYTON CHURCH (RADIOLOGIST GENERAL PARTNER) |
Authorized Official Telephone | 7062789729 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 00248245F | 05 | |
GA | RAILROAD MEDICARE | CM5117 | 01 |
Other Name | Type Code |
---|---|
Dalton Imaging Center | Doing Business As Name - Organization |
Street Address |
1502 NORTH THORNTON AVE |
City | DALTON |
State | GA |
Zip Code | 30720 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528688421 | Nighat Purnima Kabir | Student in an Organized Health Care Education/Training Program | Hamilton Medical Center, Attn: Residency Program, 1200 Memorial Drive, Dalton, GA 30720 | 2020-04-21 |
1720620727 | Elizabeth Nicole Gregory | Behavioral Analyst | 1201 Burleyson Rd., Dalton, GA 30720 | 2019-10-10 |
1972161768 | Andrea Nicole Henry | Speech-Language Pathologist | 1201 Burleyson Road, Dalton, Ga. 30720, Dalton, GA 30720 | 2019-06-05 |
1275056905 | Cynthia L Wood | Speech-Language Pathologist | 1011 Professional Blvd., Dalton, GA 30720 | 2017-07-25 |
1073069225 | Alyssa Sellers Garner | Nurse Practitioner | 1436 Chattanooga Avenue, Dalton, GA 30720 | 2016-08-28 |
1588039077 | Katie Walker | Social Worker | 900 Shugart Road, Dalton, GA 30720 | 2015-12-09 |
1215310800 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 98 West Walnut Ave, Dalton, GA 30720 | 2015-07-01 |
1275969081 | Stacy Kay Whitehead | Nurse Practitioner | 1411 Chattanooga Avenue, Suite 101, Dalton, GA 30720 | 2013-09-25 |
1821439985 | Chantal Aneka Raheeda Lewis | Internal Medicine | 1109 Burleyson Rd Ste 103, Dalton, GA 30720 | 2013-07-17 |
1174960678 | Homestead Hospice of Northwest Georgia, LLC | Hospice Care, Community Based | 1601 Hickory Street, Dalton, GA 30720 | 2013-05-24 |
Find all providers in zip 30720 |
Taxonomy Code | 261QR0200X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Radiology |
Definition to come... |
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1881218964 | American Health Imaging of Georgia LLC | Clinic/Center | 30 Janet Dr, Savannah, GA 31405-5518 | 2020-06-03 |
1952948291 | Catching Point Physician Centers, LLC | Clinic/Center | 3333 Old Milton Pkwy Ste G100, Alpharetta, GA 30005-0008 | 2019-12-05 |
1447802780 | American Health Imaging of Ga LLC | Clinic/Center | 2851 Washington Rd, Augusta, GA 30909-2131 | 2019-07-16 |
1700445582 | American Health Imaging of Ga LLC | Clinic/Center | 4374 Atlanta Hwy Ste 125, Hiram, GA 30141-1852 | 2019-06-06 |
1508425380 | American Health Imaging of Ga LLC | Clinic/Center | 796 Church St Ne Ste 100, Marietta, GA 30060-7228 | 2019-06-06 |
1588229918 | Synergy Radiology, LLC | Clinic/Center | 6025 Professional Pkwy Ste 104, Douglasville, GA 30134-5610 | 2019-05-01 |
1134645351 | M & B Imaging, PC | Clinic/Center | 2485 Jefferson Rd, Athens, GA 30607-1202 | 2017-08-18 |
1548785330 | American Health Imaging of Georgia LLC | Clinic/Center | 1103 Fountain Lake Dr, Brunswick, GA 31525-3039 | 2017-08-14 |
1164966461 | Pro Radiology, LLC | Clinic/Center | 60 Peachtree Park Dr Ne, Atlanta, GA 30309-1304 | 2016-12-06 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.