Healthcare Provider Details

I. General information

NPI: 1174479141
Provider Name (Legal Business Name): VITAL ACCURATE LEADING OPERATIONAL RADIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 E BRADFORD PKWY
SPRINGFIELD MO
65804-6566
US

IV. Provider business mailing address

1505 E BRADFORD PKWY
SPRINGFIELD MO
65804-6566
US

V. Phone/Fax

Practice location:
  • Phone: 417-281-0053
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: THOMAS LEEWAYNE COBB
Title or Position: COO
Credential:
Phone: 417-281-0053