MEDICARE: MEDICAL IMAGING CONNECTIONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0200X	Radiology Clinic/Center
2	261QR0208X	Mobile Radiology Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	094605	OTHER	MT	BCBS OF MONTANA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417028648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL IMAGING CONNECTIONS

Provider Business Mailing Address
First Line	:	1220 2ND ST W
Second Line	:	P.O. BOX 931
City	:	ROUNDUP
State	:	MT
Zip	:	59072-1836
Country	:	US
Telephone Number	:	406-323-7226
Fax Number	:	206-339-7486

Provider Business Practice Location Address
First Line	:	1220 2ND ST W
Second Line	:
City	:	ROUNDUP
State	:	MT
Zip	:	59072-1836
Country	:	US
Telephone Number	:	406-323-7226
Fax Number	:	206-339-7486

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KEN G KELLUM
Credential	:
Telephone Number	:	406-323-7226

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	09/11/2025

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Directions to “MEDICAL IMAGING CONNECTIONS ” Practice Location

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