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Organization
RADIOLOGY CLINIC
Active
Organization
RADIOLOGY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILLY L SULLIVAN M.D. (OWNER)
(662) 328-8404
Entity
Organization
Contact information
Practice address
2400 FIFTH STREET NORTH, COLUMBUS, MS 39705-2000
(662) 328-8404
(662) 329-4645
Mailing address
2400 FIFTH STREET NORTH, COLUMBUS, MS 39705-2000
(662) 328-8404
(662) 329-4645
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
08/27/2008
Last updated
08/27/2008
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