Thomas R Fuller (NPI# 1508848961, PAC ID# 0547258089) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1508848961 |
| PAC ID by PECOS | 0547258089 |
| Professional Enrollment ID | I20040504000768 |
| Full Name | Thomas R Fuller |
| Organization Legal Name | HIRAM IMAGING, LLC |
| Address |
4374 Atlanta Hwy 125 Hiram GA 30141-1849 |
| Phone Number | 6789411777 |
| Gender | M |
| Credential | MD |
| Medical School | VANDERBILT UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1972 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 7911216221 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110115 | WELLSTAR ATLANTA MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 303 Pkwy Dr Ne, Atlanta, GA 30312-1212 | 4042654000 | DIAGNOSTIC IMAGING SPECIALISTS PA |
| 4374 Atlanta Hwy 125, Hiram, GA 30141-1849 | 6789411777 | HIRAM IMAGING, LLC |
| 796 Church St Ne, Suite 100, Marietta, GA 30060-7228 | 6787368908 | MARIETTA IMAGING, LLC |
| Organization Legal Name | HIRAM IMAGING, LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael I Chaliff | Diagnostic Radiology | Hiram Imaging, LLC | 4374 Atlanta Hwy 125, Hiram, GA 30141-1849 |
| Street Address |
4374 ATLANTA HWY 125 |
| City | HIRAM |
| State | GA |
| Zip | 30141-1849 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael I Chaliff | Diagnostic Radiology | Hiram Imaging, LLC | 4374 Atlanta Hwy 125, Hiram, GA 30141-1849 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Samantha Lavengood Boucher | Chiropractic | 5447 Powder Springs Dallas Swrd, Hiram, GA 30141 | |
| Aubree L Tant | Nurse Practitioner | Wellstar Medical Group, LLC | 176 Charles Hardy Pkwy C, Hiram, GA 30141-1836 |
| Christina Adams | Family Medicine | Wellstar Medical Group, LLC | 176 Charles Hardy Pkwy C, Hiram, GA 30141-1836 |
| Carl Goolsby | Family Medicine | Wellstar Medical Group, LLC | 176 Charles Hardy Pkwy C, Hiram, GA 30141-1836 |
| Laura C Huenink | Nurse Practitioner | Wellstar Medical Group, LLC | 176 Charles Hardy Pkwy C, Hiram, GA 30141-1836 |
| Jeffrey Lanier Tharp | Internal Medicine | Wellstar Medical Group, LLC | 176 Charles Hardy Pkwy C, Hiram, GA 30141-1836 |
| Ramona Payton | Nurse Practitioner | Wellstar Medical Group, LLC | 176 Charles Hardy Pkwy C, Hiram, GA 30141-1836 |
| Roderick H Rhyant | Family Medicine | Wellstar Medical Group, LLC | 176 Charles Hardy Pkwy C, Hiram, GA 30141-1836 |
| Susan E Ashworth | Nurse Practitioner | Wellstar Medical Group, LLC | 176 Charles Hardy Pkwy C, Hiram, GA 30141-1836 |
| David A Gose | Internal Medicine | Wellstar Medical Group, LLC | 176 Charles Hardy Pkwy C, Hiram, GA 30141-1836 |
| Find all physicians in zip 30141 | |||
| City | HIRAM |
| Zip Code | 30141 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | HIRAM + DIAGNOSTIC RADIOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.