| NPI | 1750646436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD WALKER BYARS Secretary 662-234-4744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology (Licence: MS 36-2-026) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 291U00000X Clinical Medical Laboratory (Licence: MS 25D2049358) | |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2014-02-05 |