EVANS IMAGING LLC NPI 1144407750

NPI Information

NPI: 1144407750
Provider Name: EVANS IMAGING, LLC
Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

CLIA Number: 11D2080982

Address:
4350 TOWNE CENTER DRIVE
SUITE 1000
EVANS, GA
ZIP 30809
Phone: (706) 868-3940
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EVANS IMAGING, LLC is a radiology clinic center in Evans, GA. EVANS IMAGING, LLC NPI is 1144407750. The provider is registered as an organization entity type.

The provider's business location address is:

4350 TOWNE CENTER DRIVE
SUITE 1000
EVANS, GA
ZIP 30809
Phone: (706) 868-3940
Fax: (706) 868-3979

The provider's authorized official is Steven G. Rogers .
The authorized official title is Medical Director and has the following contact phone number (706) 737-4575.

The CLIA number assigned to this NPI record is 11D2080982 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/25/2008 and was last updated on 12/11/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0206X	Clinic/Center	Radiology, Mammography		GEORGIA	No
2	261QR0200X	Clinic/Center	Radiology		GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	000370048U	MEDICAID	GEORGIA
2	GPA958	MEDICAID	SOUTH CAROLINA
3	511G470019	MEDICARE PIN	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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