Healthcare Provider Details

I. General information

NPI: 1598623522
Provider Name (Legal Business Name): EMERGENCE RADIOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1249 E MONTCLAIR ST
SPRINGFIELD MO
65804-4255
US

IV. Provider business mailing address

1249 E MONTCLAIR ST
SPRINGFIELD MO
65804-4255
US

V. Phone/Fax

Practice location:
  • Phone: 877-681-2977
  • 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: DEAN MOESCH
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 877-681-2977