Healthcare Provider Details

I. General information

NPI: 1417028648
Provider Name (Legal Business Name): MEDICAL IMAGING CONNECTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 2ND ST W
ROUNDUP MT
59072-1836
US

IV. Provider business mailing address

1220 2ND ST W P.O. BOX 931
ROUNDUP MT
59072-1836
US

V. Phone/Fax

Practice location:
  • Phone: 406-323-7226
  • Fax: 206-339-7486
Mailing address:
  • Phone: 406-323-7226
  • Fax: 206-339-7486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KEN G KELLUM
Title or Position: PRESIDENT
Credential:
Phone: 406-323-7226