National Provider Identifier Database

MID SOUTH IMAGING THERAPEUTICS PA
Diagnostic Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.


Contact Information

MID-SOUTH IMAGING & THERAPEUTICS, P.A.
7600 WOLF RIVER BLVD.
#200
GERMANTOWN, TN38138
Phone: 901-747-1000
Fax: 901-747-1001
Website:
Specialty Taxonomy Code
* Diagnostic Radiology 2085R0202X
Nurse Anesthetist, Certified Registered 367500000X
Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for MID-SOUTH IMAGING & THERAPEUTICS, P.A.

NPI Number 1043260763
Legal business name
LBN
MID-SOUTH IMAGING & THERAPEUTICS, P.A.
Authorized official JOHN ELLZEY - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 05/11/2006
Last updated 10/16/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • AR Medicaid: 107365002
  • MO Medicaid: 508212206
  • MS Medicaid: 09013816
  • TN Medicaid: 3373325
  • AR Other: 86018 GROUP AR BCBS #
  • TN Other: 0022687 GROUP TN BCBS #

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for MID-SOUTH IMAGING & THERAPEUTICS, P.A.

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