NPI 1023878634
Clinic/Center - Radiology in Macon, GA
Active since March 20, 2024
About NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NPPES Registry Identity
NPI1023878634
Entity TypeOrganization
Primary Taxonomy261QR0200X
Location Address555 1ST STMacon, GA 31201-2825
Mailing AddressPo Box 4645Macon, GA 31208-4645 · (478) 744-9603 · Fax (478) 744-9552
Phone(478) 744-9603
Fax(478) 744-9552
Organization SubpartNo
Authorized OfficialIyabo MurainaBusiness Manager · (478) 744-9603
Enumeration DateMarch 20, 2024
NPPES CertifiedMarch 20, 2024
✔ NPI 1023878634 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyClinic/Center · RadiologyAmbulatory Health Care Facilities
Taxonomy Code261QR0200X
555 1ST ST, Macon, GA 31201
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
# NPI 1023878634 · NPI 1023878634
Radiology organization in Macon, Georgia. Organization record, active in the CMS NPPES registry since March 20, 2024.
## Identity
- **NPI:** 1023878634 (Entity type: Organization)
- **Enumerated:** March 20, 2024
- **Primary specialty:** Clinic/Center - Radiology · taxonomy 261QR0200X
- **Organization subpart:** No
- **Authorized official:** Iyabo Muraina, BUSINESS MANAGER
## Practice location
- **Address:** 555 1ST ST, Macon, GA 31201-2825
- **Phone:** (478) 744-9603 · **Fax:** (478) 744-9552
## Record status
- **NPPES last updated:** March 20, 2024
---
Source: [NPI Profile](https://npiprofile.com/npi/1023878634) · Data from the CMS NPPES public registry.