Marietta Imaging Center Marietta Imaging At North Cobb

LBN: Marietta Diagnostic Center, Llc
Marietta Imaging Center Marietta Imaging At North Cobb is an health care organization with primary practice located at 780 Canton Road Ne Suite 230, Marietta GA 30060-8928. The organization recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound, Ambulatory Health Care Facilities / Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is the primary health care specialty. Marietta Diagnostic Center, Llc can be contacted via phone (770) 792-1234, or through Evertseb, Mike via phone (770) 792-1234.

Contact Information

Primary practice address
780 Canton Road Ne Suite 230 Marietta GA 30060-8928
Phone: (770) 792-1234
Fax: (770) 424-1194
Website:
Map and Directions
Authorized official contact:
Name: Evertseb, Mike
Phone: (770) 792-1234

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X
Allopathic & Osteopathic Physicians / Nuclear Radiology 2085N0904X
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X
Allopathic & Osteopathic Physicians / Diagnostic Ultrasound 2085U0001X
Ambulatory Health Care Facilities / Radiology 261QR0200X

Profile Details

NPI number 1154371805
LBN Legal business name Marietta Diagnostic Center, Llc
DBA Doing business as Marietta Imaging Center Marietta Imaging At North Cobb
Authorized official Evertseb, Mike
Entity Organization
Organization subpart 1 Yes
Enumeration date May 12th, 2006
Last updated Apr 25th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154371805 NPPES
Georgia MEDICAID 764269020A

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