Organization
PREMIER RADIOLOGY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY CARLTON HOWARD MD (PRESIDENT)
(662) 620-7102
Entity
Organization
Contact information
Practice address
620 CROSSOVER ROAD, TUPELO, MS 38801
(662) 620-7101
Mailing address
620 CROSSOVER RD, TUPELO, MS 38801-4944
(662) 842-1758
(662) 844-8298
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2954
MEDICARE
AL
05
—
529700060
—
AL
05
—
9011191
—
MS
01
—
CE6077
RAILROAD MEDICARE
MS
Enumeration date
05/24/2006
Last updated
06/23/2020
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