ALLEGIANCE IMAGING AND RADIOLOGY LLC NPI 1902346422

NPI Information

NPI: 1902346422
Provider Name: ALLEGIANCE IMAGING AND RADIOLOGY, LLC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

CLIA Number: 11D2157347

Address:
4375 JOHNS CREEK PKWY STE 300
SUWANEE, GA
ZIP 30024
Phone: (404) 523-3680
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ALLEGIANCE IMAGING AND RADIOLOGY, LLC is a diagnostic radiology radiology in Suwanee, GA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. ALLEGIANCE IMAGING AND RADIOLOGY, LLC NPI is 1902346422. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4375 JOHNS CREEK PKWY STE 300
SUWANEE, GA
ZIP 30024-086
Phone: (404) 523-3680
Fax: (404) 478-9306

The provider's authorized official is Kurt Holden Taylor .
The authorized official title is President and has the following contact phone number (404) 937-3046.

The CLIA number assigned to this NPI record is 11D2157347 - other - diagnostic imaging center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/2/2017 and was last updated on 10/18/2023.

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	2085R0202X	Radiology	Diagnostic Radiology			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	Other Provider Identifier Issuer
1	003203580A	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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