NPIMap

Organization Active NPI

Miss-Lou CT Center, LLC

  • Radiology Clinic/Center
  • Natchez, MS
National Provider Identifier
1902004997
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
012022 Issued in MS
Legal business name
MISS-LOU CT CENTER, LLC
Practice address
140 Jeff Davis Blvd
Suite B
Natchez, MS 39120-5104
Phone
(601) 304-9718
Fax
(601) 304-9637
NPI assigned
Jul 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Vikramaditya Dulam, M.D.
Title
Member/Manager
Phone
(601) 304-9718

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 012022 MS Primary

Addresses

Primary practice location

140 Jeff Davis Blvd
Suite B
Natchez, MS 39120-5104

Mailing address

140 Jeff Davis Blvd
Suite B
Natchez, MS 39120-5104
Phone (601) 304-9718

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1902004997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 JEFF DAVIS BLVD",
            "address_2": "SUITE B",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391205104",
            "telephone_number": "601-304-9718",
            "fax_number": "601-304-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 JEFF DAVIS BLVD",
            "address_2": "SUITE B",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391205104",
            "telephone_number": "601-304-9718",
            "fax_number": "601-304-9637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISS-LOU CT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "DULAM",
        "authorized_official_first_name": "VIKRAMADITYA",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "601-304-9718",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "MS",
            "license": "012022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchez, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.