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DIAGNOSTIC RADIOLOGY PC VEIN CLINIC NPI 1144650938


NPI Information

NPI: 1144650938
Provider Name: DIAGNOSTIC RADIOLOGY PC VEIN CLINIC
Classification: Radiology - 2085R0204X
Entity Type: Organization

Specialization: Vascular & Interventional Radiology

Address:
26136 US HIGHWAY 59
FAIRFAX, MO
ZIP 64446
Phone: (308) 647-6444
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DIAGNOSTIC RADIOLOGY PC VEIN CLINIC is a vascular and interventional radiology radiology in Fairfax, MO. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. DIAGNOSTIC RADIOLOGY PC VEIN CLINIC NPI is 1144650938. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

26136 US HIGHWAY 59
FAIRFAX, MO
ZIP 64446-105
Phone: (308) 647-6444
Fax: (866) 902-2445

The provider's authorized official is Jo A Pohl .
The authorized official title is Billing Manager and has the following contact phone number (308) 647-6444.

The enumeration date for this NPI number is 11/15/2013 and was last updated on 11/15/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0204XRadiologyVascular & Interventional RadiologyYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1MA3807MEDICARE 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: 4/28/2024

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