Organization
ASSOCIATED RADIOLOGISTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SAUNDRA RENA SHANNON (OFFICE MANAGER)
(601) 835-5411
Entity
Organization
Contact information
Practice address
108 LANCE ALWORTH DR, BROOKHAVEN, MS 39601-2300
(601) 833-6011
(601) 835-5413
Mailing address
PO BOX 764, BROOKHAVEN, MS 39602-0764
(601) 833-6011
(601) 835-5413
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09011113
—
MS
Enumeration date
10/18/2005
Last updated
08/22/2020
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