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Individual

JOHN A BANAHAN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2809 DENNY AVE, PASCAGOULA, MS 39581-5301
(228) 762-1353
(228) 762-1359
Mailing address
1365 MARKET ST, PASCAGOULA, MS 39567-6604
(228) 762-1353
(228) 762-1359

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
24796
MS
2085R0202X
Diagnostic Radiology Physician
Primary
32065
AL

Other

Enumeration date
04/25/2011
Last updated
07/21/2022
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