Provider Demographics
NPI:1336371418
Name:STARKVILLE RADIOLOGY PLLC
Entity Type:Organization
Organization Name:STARKVILLE RADIOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BUEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-328-2476
Mailing Address - Street 1:PO BOX 2709
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70459-2709
Mailing Address - Country:US
Mailing Address - Phone:985-646-0691
Mailing Address - Fax:985-646-0750
Practice Address - Street 1:400 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2163
Practice Address - Country:US
Practice Address - Phone:662-323-4320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS192422085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSDP9981OtherMEDICARE RAILROAD
MS07679520Medicaid
MSDP9981OtherMEDICARE RAILROAD
MS07679520Medicaid