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General NPI Number Information
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NPI Number | 1184185092
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Entity Type | Organization
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Legal Business Name | NORTH MISSISSIPPI RADIOLOGY SERVICES LLC
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 03/26/2019
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Provider Practice Location Address
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Address Line | 7420 GUTHRIE DR N STE 105
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City | SOUTHAVEN
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State | MS
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Zip | 38671-5857
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Country | US
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Telephone | 662-349-4321
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Fax | 662-349-3263
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Provider Business Mailing Address
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Address Line | 2527 CRANBERRY HWY
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City | WAREHAM
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State | MA
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Zip | 02571-1046
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Country | US
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Telephone | 800-841-5200
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Fax | 508-273-1241
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Authorized Official
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Title or Position | PRESIDENT / MD
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Name | DR. LOI T. VU
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Credential | MD
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Telephone | 800-841-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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