Provider Demographics
NPI:1982724209
Name:MEDIX RADIOLOGY SERVICES LLC
Entity type:Organization
Organization Name:MEDIX RADIOLOGY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-840-2977
Mailing Address - Street 1:4780 ASHFORD DUNWOODY RD
Mailing Address - Street 2:SUITE A-433
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-5504
Mailing Address - Country:US
Mailing Address - Phone:866-840-2977
Mailing Address - Fax:
Practice Address - Street 1:4780 ASHFORD DUNWOODY RD
Practice Address - Street 2:SUITE A-433
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-5504
Practice Address - Country:US
Practice Address - Phone:866-840-2977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0356342085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty