| NPI | 1407364482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON B. CROWDER Partner/Co Owner 228-731-7114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2018-06-05 |