NPI 1811255896 · live from the CMS NPI Registry
Joseph Mullasseril John, D.O,
Radiology, Diagnostic Radiology in Shreveport, LA. National Provider Identifier 1811255896, active.
NPI record
| NPI | 1811255896 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 2600 Greenwood Rd, Shreveport, LA 71103 |
| Practice phone | 318-212-4000 |
| Mailing address | Po Box 3488, Tupelo, MS 38803 |
| Enumerated | April 27, 2012 |
| Last updated | July 26, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Diagnostic Radiology | 2085R0202X | R0258 (TX) |
| Radiology, Diagnostic Radiology primary | 2085R0202X | 310128 (LA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.