| NPI | 1679775001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE F JACOBS Owner 662-334-9829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 10589) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2012-07-13 |