| Organization Name: | SIVAD IMAGING LLC |
| NPI Number: | 1730354465 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROGER L DAVIS (CEO, PRESIDENT) |
| Mailing Address: | 4851 Orchard Hill Dr Grovetown |
| State: | GA US |
| Postal Code: | 308136324 |
| Phone Number: | 7068632872 |
| Fax Number: | 7068632872 |
| NPI Enumeration Date: | 04/23/2008 |
| NPI Last Update Date: | 01/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246XS1301X |
| License Number: | 15623 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Spec/Tech, Cardiovascular |
| Taxonomy Specialization: | Sonography |
| Taxonomy Definition: | |