Healthcare Provider Details

I. General information

NPI: 1316968019
Provider Name (Legal Business Name): IMAGES USA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 WEST DEYOUNG HEARTLAND REGIONAL MEDICAL CENTER DEPT OF RADIOLOGY
MARION IL
62959
US

IV. Provider business mailing address

PO BOX 503809 IMAGES USA INC
ST LOUIS MO
63150-3809
US

V. Phone/Fax

Practice location:
  • Phone: 618-998-7655
  • Fax:
Mailing address:
  • Phone: 800-775-9195
  • Fax: 309-688-5562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: BRUCE JC HOULE
Title or Position: PRESIDENT
Credential: DO
Phone: 618-998-7655