Provider Demographics
NPI:1447326178
Name:HIGH FIELD OPEN MRI
Entity type:Organization
Organization Name:HIGH FIELD OPEN MRI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONAL MANAGER PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSWAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-649-8500
Mailing Address - Street 1:10630 ALPHARETTA WAY
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076
Mailing Address - Country:US
Mailing Address - Phone:770-649-8500
Mailing Address - Fax:770-649-8591
Practice Address - Street 1:10630 ALPHARETTA WAY
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076
Practice Address - Country:US
Practice Address - Phone:770-649-8500
Practice Address - Fax:770-649-8591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006802085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA43199OtherCHRISTOPHER D DOOLEY LIC
GA9453OtherJAY S COFFSKY MD LICENSE
GA48479OtherKELVIN K BELCHER MD LIC #
GA9460OtherFRANK T DALY MD LICENSE #
24262OtherHIXSON L GORDON MD LIC #
GA55123OtherLINTON W EBERHARDT MD LIC
GA13607OtherROBERT L DAVLES MD LIC #
E40101Medicare UPIN
E96049Medicare UPIN
F76024Medicare UPIN
GA47BBBDCMedicare ID - Type Unspecified
E40095Medicare UPIN
E40220Medicare UPIN
GA13607OtherROBERT L DAVLES MD LIC #
G14552Medicare UPIN
C76143Medicare UPIN
GA9460OtherFRANK T DALY MD LICENSE #
E40096Medicare UPIN
24262OtherHIXSON L GORDON MD LIC #
E40099Medicare UPIN