Organization
MERIDIAN IMAGING, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL STACY THAGGARD M.D. (PRESIDENT)
(601) 693-5843
Entity
Organization
Contact information
Practice address
1102 CONSTITUTION AVE, FIRST FLOOR, MERIDIAN, MS 39301-4001
(601) 693-5843
(601) 693-0173
Mailing address
PO BOX 5653, MERIDIAN, MS 39302-5653
(601) 693-5843
(601) 693-0173
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Enumeration date
11/13/2007
Last updated
06/29/2015
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