| Organization Name: | SOUTHERN MOLECULAR IMAGING, LLC |
| NPI Number: | 1356584924 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM C LAVELY (OWNER) |
| Mailing Address: | 2001 Professional Pkwy Suite 160 Woodstock |
| State: | GA US |
| Postal Code: | 301886444 |
| Phone Number: | 9128564032 |
| Fax Number: | |
| NPI Enumeration Date: | 04/13/2009 |
| NPI Last Update Date: | 05/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |