JEFFERSON CITY MEDICAL GROUP P.C. NPI 1508806563

NPI Information

JEFFERSON CITY MEDICAL GROUP, P.C. is a diagnostic radiology radiology in Jefferson City, MO. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. JEFFERSON CITY MEDICAL GROUP, P.C. NPI is 1508806563. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Jefferson City Radiologists.

The provider's business location address is:

1241 W STADIUM BLVD
LOWER LEVEL
JEFFERSON CITY, MO
ZIP 65109-023
Phone: (573) 556-5747
Fax: (573) 636-9756

The provider's authorized official is Jeffrey Lee Patrick .
The authorized official title is President and has the following contact phone number (573) 635-5264.

The CLIA number assigned to this NPI record is 26D2218615 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/7/2006 and was last updated on 5/9/2023.

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:

Other Identifiers

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

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