| NPI | 1265651459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR SCOTT FERGUSON Physician Radiologist 870-735-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR C6304) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD14662) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |