| NPI | 1407634702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA WASHINGTON Credentialing & Billing Supervisor 501-255-4056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2024-05-10 |