Provider Demographics
NPI:1386609303
Name:DIAGNOSTIC IMAGING SOLUTIONS
Entity type:Organization
Organization Name:DIAGNOSTIC IMAGING SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:LATTIMER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-546-5000
Mailing Address - Street 1:2140 BUFORD HWY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-6120
Mailing Address - Country:US
Mailing Address - Phone:678-546-5000
Mailing Address - Fax:678-546-0055
Practice Address - Street 1:2140 BUFORD HWY
Practice Address - Street 2:SUITE 108
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-6120
Practice Address - Country:US
Practice Address - Phone:678-546-5000
Practice Address - Fax:678-546-0055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000710091QMedicaid
GAP00203634Medicare PIN
GA000710091QMedicaid