Organization Name: | MPPG, INC. |
NPI Number: | 1174691067 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR) |
Mailing Address: | 200 Maple Drive Vidalia |
State: | GA US |
Postal Code: | 30474 |
Phone Number: | 9123505961 |
Fax Number: | 9123505942 |
NPI Enumeration Date: | 12/01/2006 |
NPI Last Update Date: | 06/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0204X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Vascular & Interventional Radiology |
Taxonomy Definition: | A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |