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NPI Code Detail

MEDICARE: CT IMAGING SERVICE

MEDICARE: CT IMAGING SERVICE
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
12085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A002754OTHERIACHAMPUS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3IA100OTHERIAJOHN DEERE HEALTH
420094OTHERIABLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number : 1982661948
Entity Type Code : Organization
Provider Name (Legal Business Name) : CT IMAGING SERVICE
Provider Business Mailing Address
First Line : 1001 PENNSYLVANIA AVE
Second Line :
City : OTTUMWA
State : IA
Zip : 52501-6427
Country : US
Telephone Number : 641-683-4451
Fax Number : 641-684-2931
Provider Business Practice Location Address
First Line : 1001 PENNSYLVANIA AVE
Second Line :
City : OTTUMWA
State : IA
Zip : 52501-6427
Country : US
Telephone Number : 641-683-4451
Fax Number : 641-684-2931
Authorized Official
Title or Position : ACTING MANAGER
Name : DR. GERALD PALUSKA
Credential : MD
Telephone Number : 641-683-4451
Provider Enumeration Date : 04/26/2006
Last Update Date : 08/22/2020

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Practice Fax:
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Practice Fax:
1114999810 — MR. LONNIE LEE LANFERMAN DO
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1154374056 — RADIATION ONCOLOGY PC
Practice Location Address:
1001 PENNSYLVANIA AVE
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52501-6427
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Practice Fax: 641-684-2479

Directions to “CT IMAGING SERVICE ” Practice Location

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