# PORTABLE MEDICAL DIAGNOSTICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326384306
- **Authorized official:** DOUGLAS BROWN (MANAGING MEMBER)
- **Authorized official phone:** (601) 987-9729

## Contact information

- **Practice address:** 9047 HOME AVE, IRVINGTON, AL 36544-2855
- **Practice address phone:** (251) 272-1080
- **Practice address fax:** (251) 272-1080
- **Mailing address:** 1855 LAKELAND DR, SUITE G10, JACKSON, MS 39216-4913
- **Mailing address phone:** (601) 987-9729
- **Mailing address fax:** (601) 987-0093

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | AL | Yes |

## Other

- **Enumeration date:** 12/20/2012
- **Last updated:** 02/07/2013