NORTHSIDE IMAGING LLC NPI 1669829214

NPI Information

  • NPI: 1669829214
  • Provider Name: NORTHSIDE IMAGING LLC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • CLIA Number: 11D1069063
  • Address: 845 PRINCE AVE
    ATHENS, GA
    ZIP 30606
  • Phone: (706) 549-1118

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NPI Details

NORTHSIDE IMAGING LLC is a diagnostic radiology radiology in Athens, GA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. NORTHSIDE IMAGING LLC NPI is 1669829214. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

845 PRINCE AVE
ATHENS, GA
ZIP 30606-723
Phone: (706) 549-1118

The provider's authorized official is Jorge J Hernandez .
The authorized official title is Vp Admin. Services/cco and has the following contact phone number (404) 851-6378.

The CLIA number assigned to this NPI record is 11D1069063 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 5/24/2016 and was last updated on 5/24/2016.

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
12085R0202XRadiologyDiagnostic RadiologyYes

What is NPI?

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This page was last updated on: 3/30/2025

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