| Mid-south Imaging Center Llc | |
|
363 Southcrest Cir Ste 102 Southaven MS 38671-4737 | |
| (662) 772-4615 | |
| Not Available |
| Full Name | Mid-south Imaging Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 363 Southcrest Cir Ste 102, Southaven, Mississippi |
| Authorized Official Name and Position | Gregory M Duckett (SR VP/CLO) |
| Authorized Official Contact | 9012275233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-south Imaging Center Llc 350 N Humphreys Blvd Memphis TN 38120-2177 Ph: (901) 227-5233 | Mid-south Imaging Center Llc 363 Southcrest Cir Ste 102 Southaven MS 38671-4737 Ph: (662) 772-4615 |
| NPI Number | 1245966324 |
|---|---|
| Provider Enumeration Date | 07/29/2022 |
| Last Update Date | 07/29/2022 |
| Medicare PECOS PAC ID | 5294105409 |
|---|---|
| Medicare Enrollment ID | O20230104003103 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245966324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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