COASTAL PLAIN RADIOLOGY LLC NPI 1508417296

NPI Information

NPI: 1508417296
Provider Name: COASTAL PLAIN RADIOLOGY LLC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
2501 N PATTERSON ST
VALDOSTA, GA
ZIP 31602
Phone: (229) 433-1000
Get Directions

COASTAL PLAIN RADIOLOGY LLC is a diagnostic radiology radiology in Valdosta, GA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. COASTAL PLAIN RADIOLOGY LLC NPI is 1508417296. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2501 N PATTERSON ST
VALDOSTA, GA
ZIP 31602-735
Phone: (229) 433-1000

The provider's authorized official is Joshua Stephenson .
The authorized official title is Direct Owner and has the following contact phone number (205) 531-2857.

The enumeration date for this NPI number is 9/24/2019 and was last updated on 2/24/2020.

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	Primary
1	2085B0100X	Radiology	Body Imaging	No
2	2085N0700X	Radiology	Neuroradiology	No
3	2085N0904X	Radiology	Nuclear Radiology	No
4	2085P0229X	Radiology	Pediatric Radiology	No
5	2085R0202X	Radiology	Diagnostic Radiology	Yes
6	2085R0204X	Radiology	Vascular & Interventional Radiology	No
7	2085U0001X	Radiology	Diagnostic Ultrasound	No
8	2085D0003X	Radiology	Diagnostic Neuroimaging	No

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	Other Provider Identifier Issuer
1	003164753B	MEDICAID	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: 5/5/2024

NPI Synchronization or Removal

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