| NPI | 1275645798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADISON WILSON GAILLARD Administrator 662-459-7133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MS 07161) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |