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