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Contact Information

DESOTO DIAGNOSTIC IMAGING, LLC
9085 SANDIDGE CENTER COVE
SUITE 100
OLIVE BRANCH, MS38654-3575
 Phone: 662-536-1000
 Fax: 662-893-8824
 Website:
Indicates primary specialty

NPI Profile & details for DESOTO DIAGNOSTIC IMAGING, LLC

NPI Number 1083777882
LBN Legal business name DESOTO DIAGNOSTIC IMAGING, LLC
Authorized official JOHN GRAVES - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/19/2006
Last updated 11/30/2011 - About 15 years ago
Identifiers
MS Medicaid 00973276
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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