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General NPI Number Information
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NPI Number | 1174793202
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Entity Type | Individual
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Provider Name | DARREN SCOTT ALLSUP RDMS
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Gender | Male
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 146 GARDEN TERRACE DR
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City | OXFORD
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State | MS
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Zip | 38655-9329
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Country | US
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Telephone | 662-801-4062
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Fax |
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Provider Business Mailing Address
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Address Line | 146 GARDEN TERRACE DR
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City | OXFORD
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State | MS
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Zip | 38655-9329
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Country | US
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Telephone | 662-801-4062
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number | CRT74089
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number | MRT2046
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number |
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License Number State |
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