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General NPI Number Information
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NPI Number | 1184801201
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Entity Type | Organization
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Legal Business Name | MAGNOLIA IMAGING LLC
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Dates
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Enumeration Date | 01/31/2008
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 3890 BIENVILLE BLVD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-5803
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Country | US
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Telephone | 877-274-4683
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Fax | 800-310-5665
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Provider Business Mailing Address
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Address Line | 997 S PALAFOX ST
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City | PENSACOLA
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State | FL
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Zip | 32502-5977
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Country | US
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Telephone | 850-434-6674
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Fax | 850-434-9664
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Authorized Official
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Title or Position | COMPTROLLER
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Name | MRS. MICHELE L RIGGINS
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Credential |
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Telephone | 850-434-6674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2471M1202X
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Taxonomy Name | Magnetic Resonance Imaging Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2471N0900X
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Taxonomy Name | Nuclear Medicine Technology Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2471C3401X
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Taxonomy Name | Computed Tomography Radiologic Technologist
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License Number |
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License Number State |
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