Organization
OPEN MRI, LLC
Active
Other names
Cedar Lake MRI
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL PENBERG (ADMINISTRATOR)
(228) 818-0563
Entity
Organization
Contact information
Practice address
1720C MEDICAL PARK DR, BILOXI, MS 39532-2131
(228) 354-0251
(228) 396-3550
Mailing address
PO BOX 789, OCEAN SPRINGS, MS 39566-0789
(228) 818-0563
(228) 818-0519
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08882814
—
MS
Enumeration date
06/23/2005
Last updated
08/22/2020
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