Basic Information
| Provider Information | |||||||||
| NPI: | 1609830751 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALPERIN | ||||||||
| FirstName: | HENRY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1499 WALTON WAY | ||||||||
| Address2: | STE. 1400 | ||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309012603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067246100 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1120 15TH ST | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309120004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067219729 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2006 | ||||||||
| LastUpdateDate: | 10/21/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085B0100X | 016548 | GA | N | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | 2085D0003X | 016548 | GA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Neuroimaging | 2085N0700X | 016548 | GA | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085N0904X | 016548 | GA | N | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | 2085P0229X | 016548 | GA | N | Allopathic & Osteopathic Physicians | Radiology | Pediatric Radiology | 2085R0202X | 016548 | GA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085U0001X | 016548 | GA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound |
ID Information
| ID | Type | State | Issuer | Description | 00006498F | 05 | GA | MEDICAID | 1265540314 | 01 | NPI - BROWN & RADIOLOGY | OTHER | 00006498G | 05 | GA | MEDICAID | 00006498J | 05 | GA | MEDICAID | 00006498K | 05 | GA | MEDICAID | 00006498H | 05 | GA | MEDICAID | 00006498I | 05 | GA | MEDICAID | 00006498L | 05 | GA | MEDICAID | 00006498E | 05 | GA | MEDICAID | 00006498D | 05 | GA | MEDICAID | 10057948 | 01 | AMERIGROUP | OTHER | G16548 | 05 | SC | MEDICAID |