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General NPI Number Information
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NPI Number | 1285649095
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Entity Type | Organization
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Legal Business Name | IMAGING PARTNERS OF MISSOURI, LLC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14825 N OUTER 40 STE 120
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2152
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Country | US
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Telephone | 636-536-5071
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Fax | 636-536-5078
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Provider Business Mailing Address
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Address Line | 14825 N. OUTER FORTY ROAD, SUITE 120
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2152
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Country | US
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Telephone | 636-536-5071
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Fax | 636-536-5078
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Authorized Official
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Title or Position | DIRECTOR
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Name | MICHAEL C CHABOT
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Credential | D.O.
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Telephone | 636-536-5071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | LC0571429
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License Number State | MO
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