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General NPI Number Information
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NPI Number | 1548324643
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Entity Type | Organization
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Legal Business Name | WESTERN MISSOURI RADIOLOGICAL GROUP INC
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 07/02/2009
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Provider Practice Location Address
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Address Line | 19609 E 9TH ST S
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City | INDEPENDENCE
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State | MO
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Zip | 64056-3088
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Country | US
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Telephone | 816-796-1412
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Fax |
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Provider Business Mailing Address
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Address Line | 19609 E 9TH ST S
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City | INDEPENDENCE
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State | MO
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Zip | 64056-3088
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Country | US
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Telephone | 816-796-1412
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Fax | 816-796-3398
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | DEBRA WILSON
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Credential |
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Telephone | 816-796-1412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging 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 | 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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