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Organization

OPEN MRI OF JACKSON, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID BLUMENTHAL (PRESIDENT)
(601) 936-6500
Entity
Organization

Contact information

Practice address
1 LAYFAIR DR, SUITE 315, FLOWOOD, MS 39232-9717
(601) 936-6500
(601) 936-2027
Mailing address
1 LAYFAIR DR, SUITE 315, FLOWOOD, MS 39232-9717
(601) 936-6500
(601) 936-2027

Taxonomy

Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00123906
MS
Enumeration date
10/05/2006
Last updated
01/17/2012
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