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General NPI Number Information
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NPI Number | 1336101856
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Entity Type | Organization
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Legal Business Name | OZARK MOBILE IMAGING LLC
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Dates
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Enumeration Date | 04/03/2006
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 2012 CHERRY HILL DR SUITE 202E
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City | COLUMBIA
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State | MO
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Zip | 65203-5882
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Country | US
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Telephone | 816-232-2727
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Fax | 816-232-2771
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Provider Business Mailing Address
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Address Line | 306 S BELT HWY
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-3418
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Country | US
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Telephone | 816-232-2727
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Fax | 816-232-2771
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Authorized Official
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Title or Position | MEMBER
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Name | ZACHARY B EVANS
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Credential |
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Telephone | 816-232-2727
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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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Taxonomy #2
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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