Southeast Georgia Radiology

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

011416 Issued in GA

Legal business name

SOUTHEAST GEORGIA RADIOLOGY

Practice address

2000 Dan Proctor Dr
St Marys, GA 31520

Phone

(912) 466-6170

NPI assigned

May 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donald H Manning, M.D.

Title

President

Phone

(912) 466-6170

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1962614024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 SHRINE RD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31520",
            "telephone_number": "912-267-0533",
            "fax_number": "912-267-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 DAN PROCTOR DR",
            "city": "ST MARYS",
            "state": "GA",
            "postal_code": "31520",
            "telephone_number": "912-466-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST GEORGIA RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MANNING",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-466-6170",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "011416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GA",
            "identifier": "04155",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343124",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Snyder
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• Southeast Chiropractic LLC
• Southeast Georgia Health System, Inc.
• Southeast Georgia Health System, Inc.
• Bonnie Renee Spencer, LAPC
• Richard L Spencer, DDS
• St. Marys Obstetrics & Gynecology, P. C.
• St. Marys Psychiatry, Inc.
• Cassey St.Rose, LPC

• Diagnostic Radiology Physician in St Marys, GA
• Providers in St Marys, GA by specialty
• Diagnostic Radiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.