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General NPI Number Information
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NPI Number | 1861954083
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Entity Type | Organization
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Legal Business Name | FLOWOOD MISSISSIPPI IMAGING LLC
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Dates
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Enumeration Date | 04/05/2019
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 103 RIVER OAKS CT
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City | FLOWOOD
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State | MS
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Zip | 39232-9755
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Country | US
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Telephone | 601-932-3722
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Fax | 601-932-3758
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Provider Business Mailing Address
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Address Line | PO BOX 689022
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City | FRANKLIN
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State | TN
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Zip | 37068-9022
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Country | US
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Telephone | 615-465-7361
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Fax | 615-628-6877
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Authorized Official
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Title or Position | SENIOR DIRECTOR PROVIDER ENROLLMENT
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Name | JENNIFER L JACKSON
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Credential |
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Telephone | 877-892-9815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) 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 | 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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