Brookhaven Radiology PLLC
Organization Active NPI Diagnostic Radiology Physician · Brookhaven, MS
NPI 1750600102 · NPPES record last updated May 25, 2010
Key facts
- NPI
- 1750600102
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 19512 (MS)
- Legal business name
- BROOKHAVEN RADIOLOGY PLLC
- Practice address
- 427 Highway 51 N
Brookhaven, MS 39601-2350 - Phone
- (601) 948-2105
- NPI assigned
- May 25, 2010
- Organization subpart
- No
Authorized official
- Name
- William D Sones, M.D.
- Title
- Owner
- Phone
- (601) 948-2105
Practitioners 1
-
William David Sones Jr., M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101020000669 | MS | Part B Supplier - Clinic/Group Practice | 0749473932 |
Receives reassigned benefits from 1 practitioner Practice locations: Brookhaven, MS |
National Provider Directory
Locations
1012 Big Lane Dr
#D
Brookhaven, MS 39601
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | 19512 | MS | Yes |
Addresses
Primary practice location
427 Highway 51 N
Brookhaven, MS 39601-2350
Mailing address
PO Box 3867
Brookhaven, MS 39603-7867
Phone (601) 948-2105
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All providers in Brookhaven, MS · Diagnostic Radiology Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.