POPLAR BLUFF RADIOLOGY SERVICES INC NPI 1073793642

NPI Information

  • NPI: 1073793642
  • Provider Name: POPLAR BLUFF RADIOLOGY SERVICES INC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • Address: 1720 KANELL BLVD
    SUITE1
    POPLAR BLUFF, MO
    ZIP 63901
  • Phone: (573) 778-1336

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NPI Details

POPLAR BLUFF RADIOLOGY SERVICES INC is a diagnostic radiology radiology in Poplar Bluff, MO. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. POPLAR BLUFF RADIOLOGY SERVICES INC NPI is 1073793642. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1720 KANELL BLVD
SUITE1
POPLAR BLUFF, MO
ZIP 63901-009
Phone: (573) 778-1336
Fax: (573) 778-1336

The provider's authorized official is Kimberly Mcvey .
The authorized official title is Secretary/treasurer and has the following contact phone number (573) 718-0181.

The enumeration date for this NPI number is 11/12/2007 and was last updated on 10/16/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyR4N69MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000013973MEDICARE PINMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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