Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SAMUEL GRADY PUTNAM, MD
ActiveSAMUEL GRADY PUTNAM, MD is a Therapeutic Radiology healthcare provider located in SOUTHAVEN, Mississippi. NPI 1023066404 is currently active in the NPPES registry. Verify at CMS.
Therapeutic Radiology · SOUTHAVEN, MS
Registration Details
- NPI Number
- 1023066404
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 5, 2006 (20.285637437248 yrs)
- Last Updated
- May 6, 2025
- Licenses
-
25MA09575600 (NJ)MD041221E (PA)C1-0011573 (DE)MD041221E (PA)25MA09575600 (NJ)
Practice Information
- Address
-
55 PHYSICIANS LNSOUTHAVEN, MS, 386719569Browse MS providers · Browse ZIP 38671
- Phone
- 6626552136
- Fax
- 6629962214
- Primary Specialty
-
Therapeutic Radiology
2085R0204X
- Additional Specialty
- Diagnostic Radiology
- Additional Specialty
- Diagnostic Radiology
- Additional Specialty
- Therapeutic Radiology
- Additional Specialty
- Therapeutic Radiology
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.