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Organization

KO, MICHAEL

Active
Parent organization
KO'S BILLING OFFICE
Organization subpart
Yes

Provider details

NPI number
Legal business name
KO'S BILLING OFFICE
Authorized official
DR. MICHAEL KO (RADIOLOGIST)
(662) 455-9595
Entity
Organization

Contact information

Practice address
1401 RIVER RD, GREENWOOD, MS 38930-4030
(662) 455-9595
Mailing address
1401 RIVER RD, GREENWOOD, MS 38930-4030

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17150
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09015666
MS
Enumeration date
08/09/2007
Last updated
02/07/2008
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