Healthcare Provider Details

I. General information

NPI: 1083945844
Provider Name (Legal Business Name): SCAN THIS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2010
Last Update Date: 01/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 OFFICE PARK DR
OXFORD MS
38655-3606
US

IV. Provider business mailing address

PO BOX 1233
OXFORD MS
38655-1233
US

V. Phone/Fax

Practice location:
  • Phone: 662-236-5450
  • Fax: 662-513-0960
Mailing address:
  • Phone: 662-236-5450
  • Fax: 662-513-0960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: R. MICHAEL WHITMORE
Title or Position: MANAGING MEMBER
Credential:
Phone: 662-236-5450