| NPI | 1982651576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTTIS GENE BALL Physician 601-984-2538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 04163) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2020-08-22 |