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General NPI Number Information
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NPI Number | 1477500585
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Entity Type | Organization
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Legal Business Name | WEST COUNTY RADIOLOGICAL GROUP, INC.
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 615 S NEW BALLAS RD DEPT OF RADIOLOGY
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8221
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Country | US
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Telephone | 314-251-6031
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Fax | 314-991-8206
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Provider Business Mailing Address
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Address Line | 11475 OLDE CABIN RD SUITE 200
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City | SAINT LOUIS
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State | MO
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Zip | 63141-7129
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Country | US
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Telephone | 314-991-8200
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Fax | 314-991-8206
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY L. THOMASSON
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Credential | M.D.
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Telephone | 314-991-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology 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 | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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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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