Healthcare Provider Details

I. General information

NPI: 1689628869
Provider Name (Legal Business Name): WATSON IMAGING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3915 WATSON RD STE. LL2
SAINT LOUIS MO
63109-1251
US

IV. Provider business mailing address

2151 JANUARY AVE
SAINT LOUIS MO
63110-2935
US

V. Phone/Fax

Practice location:
  • Phone: 314-781-9711
  • Fax: 314-781-9768
Mailing address:
  • Phone: 314-645-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberNA
License Number StateMO

VIII. Authorized Official

Name: DR. KAREN F. GOODHOPE
Title or Position: PRESIDENT
Credential: MD
Phone: 636-282-0184