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Organization

GORTON LAB AND X-RAY, LLC

Active
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Organization

GORTON LAB AND X-RAY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SIDNEY CARLTON GORTON MD (OWNER/PHYSICIAN)
(662) 247-2105
Entity
Organization

Contact information

Practice address
107 CHURCH ST, BELZONI, MS 39038-3929
(662) 247-2105
(662) 247-4849
Mailing address
PO BOX 633, BELZONI, MS 39038-0633
(662) 247-2105
(662) 247-4849

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—

Other

Enumeration date
02/26/2007
Last updated
11/02/2010
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