Organization
RADIOLOGY DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WAITS M.D. (PRESIDENT)
(662) 322-5919
Entity
Organization
Contact information
Practice address
4777 US HIGHWAY 259, LONGVIEW, TX 75605-7668
(903) 663-7393
(903) 663-7394
Mailing address
102 PARKSIDE CV, SALTILLO, MS 38866-5003
(662) 322-5919
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
15458
MS
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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