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General NPI Number Information
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NPI Number | 1437369022
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Entity Type | Organization
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Legal Business Name | PRIOR RADIOLOGY SERVICES PA
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 12/08/2011
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Provider Practice Location Address
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Address Line | 1400 E UNION ST
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City | GREENVILLE
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State | MS
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Zip | 38703-3246
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Country | US
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Telephone | 662-334-9829
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Fax | 662-334-3529
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Provider Business Mailing Address
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Address Line | 136 FIORANELLI DR
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City | GREENVILLE
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State | MS
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Zip | 38701-7313
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Country | US
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Telephone | 662-334-9829
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Fax | 662-334-3529
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Authorized Official
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Title or Position | OWNER
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Name | DONALD S PRIOR
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Credential | MD
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Telephone | 662-334-9829
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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 | 14756
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License Number State | MS
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