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General NPI Number Information
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NPI Number | 1487659140
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Entity Type | Organization
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Legal Business Name | MEDICAL IMAGING ASSOCIATES OF MEXICO MO
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 620 E MONROE ST
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City | MEXICO
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State | MO
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Zip | 65265-2919
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Country | US
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Telephone | 573-582-5000
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Fax | 314-845-5668
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Provider Business Mailing Address
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Address Line | 201 E MONROE ST SUITE 202
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City | MEXICO
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State | MO
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Zip | 65265-2852
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Country | US
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Telephone | 800-354-1088
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Fax | 314-845-5668
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Authorized Official
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Title or Position | OWNER/RADIOLOGIST
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Name | DR. GEORGE K CYRIAC
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Credential | MD
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Telephone | 573-582-8553
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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 | MO
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