Organization
MEDICAL IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARSHALL GRAY EDMONDSON M.D. (PRESIDENT)
(662) 620-7101
Entity
Organization
Contact information
Practice address
616 CROSSOVER RD, TUPELO, MS 38801-4944
(662) 620-7101
(662) 842-1457
Mailing address
616 CROSSOVER RD, TUPELO, MS 38801-4944
(662) 620-7101
(662) 842-1457
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04984051
—
MS
05
—
529921640
—
AL
Enumeration date
05/27/2006
Last updated
07/09/2013
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