WOODLAWN MEDICAL GROUP OF ARIZONA (NPI# 1104045251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104045251 |
| Entity Type | Organization |
| Organization Name | WOODLAWN MEDICAL GROUP OF ARIZONA |
| Practice Address |
3535 Roswell Rd Suite 20 Marietta GA 30062-8826 |
| Practice Telephone | 7703034499 |
| Practice Fax Number | 7703039901 |
| Mailing Telephone | 7703034499 |
| Mailing Fax Number | 7703039901 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2007-11-01 |
| Authorized Official Name | ROBERT WARREN SCRUGGS (CEO) |
| Authorized Official Telephone | 7703034499 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2471S1302X |
Radiologic Technologist Specialization: Sonography |
07689701W | AZ | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
3535 ROSWELL RD SUITE 20 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-8826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952363442 | Advanced Oral and Maxillofacial Surgery PC | Oral & Maxillofacial Surgery | 3535 Roswell Rd, Suite 27, Marietta, GA 30062-8826 | 2006-04-03 |
| 1952750309 | Kiran Bandali | Optometrist | 3535 Roswell Rd, Ste 8, Marietta, GA 30062-8826 | 2016-06-07 |
| 1750654141 | Map Eyes LLC | Optometrist | 3535 Roswell Rd, Suite 8, Marietta, GA 30062-8826 | 2012-02-15 |
| 1124300629 | Keiko Sweigart | Massage Therapist | 3535 Roswell Rd, Suite 23, Marietta, GA 30062-8826 | 2011-09-12 |
| 1457672958 | Daniel Paul Brunner | Dentist | 3535 Roswell Rd, Suite 27, Marietta, GA 30062-8826 | 2010-06-18 |
| 1043470883 | Digital Radiographic Diagnostics, LLC | Clinic/Center | 3535 Roswell Rd, Suite-1 Building-1, Marietta, GA 30062-8826 | 2008-06-16 |
| 1073795746 | The Widen Clinic | Chiropractor | 3535 Roswell Rd, Ste. 37, Marietta, GA 30062-8826 | 2007-12-04 |
| 1205053188 | Hank Bradford | Dentist | 3535 Roswell Rd, Suite 46, Marietta, GA 30062-8826 | 2007-04-20 |
| 1700947132 | Denise Angella Hall | Dentist | 3535 Roswell Rd, Suite 14, Marietta, GA 30062-8826 | 2006-12-12 |
| 1922168046 | John E Schad | Chiropractor | 3535 Roswell Rd, Suite 6, Marietta, GA 30062-8826 | 2006-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
| Find all providers in zip 30062 | ||||
| Taxonomy Code | 2471S1302X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Sonography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093195497 | Holly Strickland | Radiologic Technologist | 122 Washington St Ste 7, Jefferson, GA 30549-6660 | 2015-06-02 |
| 1164818159 | Sydnay Rhynes | Radiologic Technologist | 1383 Coalition Cir, Hinesville, GA 31313-9163 | 2015-04-07 |
| 1255737615 | Tami Rider | Radiologic Technologist | 200 Carlie Ct, Hinesville, GA 31313-3810 | 2014-11-13 |
| 1073919437 | Janice Miller | Radiologic Technologist | 876 Tom Odum Rd, Vidalia, GA 30474-7105 | 2014-11-13 |
| 1619373073 | Karen Herring | Radiologic Technologist | 268 John Greco Ln, Pembroke, GA 31321-8583 | 2014-11-13 |
| 1174940654 | Quality Scans Inc | Radiologic Technologist | 415 Winterwood Dr, Stockbridge, GA 30281-1160 | 2014-03-24 |
| 1831513183 | Carrie Lynn Stoffer | Radiologic Technologist | 28 Currahee Pt, Toccoa, GA 30577-7297 | 2014-02-06 |
| 1154582955 | William Niebauer | Radiologic Technologist | 21 Youngblood Dr, Rossville, GA 30741-3858 | 2008-06-24 |
| 1407476013 | Keisha A Murray | Radiologic Technologist | 5337 Old National Hwy, College Park, GA 30349-3208 | 2020-04-23 |
| 1447650841 | Tanya Sumoski | Radiologic Technologist | 1061 Harmon Avenue, Ft. Stewart, GA 31314 | 2014-09-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.