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General NPI Number Information
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NPI Number | 1730953431
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Entity Type | Organization
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Legal Business Name | MIDSOUTH SONOGRAMS LLC
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 58 DOCTORS DR
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City | MUNFORD
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State | TN
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Zip | 38058-6301
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Country | US
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Telephone | 901-494-2038
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Fax |
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Provider Business Mailing Address
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Address Line | 1153 CHARLES PL
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City | MUNFORD
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State | TN
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Zip | 38058-4746
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Country | US
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Telephone | 901-494-2038
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VERONICA LEANN RODGERS
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Credential | RDMS
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Telephone | 901-494-2038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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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 | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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