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General NPI Number Information
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NPI Number | 1063445096
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Entity Type | Organization
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Legal Business Name | SCOTT RADIOLOGICAL GROUP INC
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 08/25/2009
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Provider Practice Location Address
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Address Line | 1420 HIGHWAY 61 SOUTH
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City | FESTUS
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State | MO
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Zip | 63028-4108
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Country | US
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Telephone | 314-647-2344
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Fax | 314-647-5108
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Provider Business Mailing Address
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Address Line | 2344 HAMPTON AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63139-2909
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Country | US
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Telephone | 314-647-2344
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Fax | 314-647-5108
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | JAMES A JUNKER
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Credential | M. D.
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Telephone | 314-647-2344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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