| NPI | 1568558385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE STUART Credentialing Representative 2 601-200-4880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2023-02-27 |