Provider Demographics
NPI:1346464534
Name:SOUTHERN RADIOLOGY SERVICES
Entity Type:Organization
Organization Name:SOUTHERN RADIOLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:POLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:225-293-3363
Mailing Address - Street 1:5545 SUPERIOR DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-8030
Mailing Address - Country:US
Mailing Address - Phone:225-293-3363
Mailing Address - Fax:225-293-0245
Practice Address - Street 1:300 CAHABA VALLEY CIR
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1148
Practice Address - Country:US
Practice Address - Phone:205-987-0333
Practice Address - Fax:800-317-2757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory