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Physicians Radiology Diagnostic Radiology

Provider NPI: 1659597136

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 417-269-4056  Fax: --

Business Mailing Address:
Tel: 417-889-6102  Fax: 417-889-6289

NPI Information:
NPI: 1659597136
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Diagnostic Radiology
Nuclear Medicine
Nuclear Medicine
Nuclear Medicine
Nuclear Medicine

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 2085R0202X





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