Organization
MID SOUTH RADIOLOGY PARTNERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARYL MILLER (CHIEF OPERATING OFFICER)
(866) 546-6643
Entity
Organization
Contact information
Practice address
107 E SHANKLAND AVE, JENNINGS, LA 70546-4709
(337) 824-4525
(337) 824-4199
Mailing address
107 E SHANKLAND AVE, JENNINGS, LA 70546-4709
(866) 546-6643
(337) 824-4199
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1446726
—
LA
Enumeration date
07/25/2006
Last updated
05/01/2009
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