Graduated: 2021
NPI: 1528734282
Practice Locations (2)
LAKELAND RADIOLOGISTS P A
969 LAKELAND DR
JACKSON, MS 392164606
6012002000
ST. DOMINIC JACKSON MEMORIAL
969 LAKELAND DR
JACKSON, MS 392164606
6013646175
Source: CMS National Downloadable File, September 2026.