Individual
MR. FREDERICK J DAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.R.A. (ARRT)(R) RPA
Contact information
Practice address
830 S GLOSTER ST, TUPELO, MS 38801-4996
(662) 377-5232
Mailing address
111 JEAN JANE LN, TUPELO, MS 38804-9113
(603) 661-5485
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
09125
MA
243U00000X
Radiology Practitioner Assistant
Primary
RA00005
MS
2471V0106X
Vascular-Interventional Technology Radiologic Technologist
09125
MA
Other
Enumeration date
07/06/2006
Last updated
01/29/2025
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