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NPI Code Detail

MEDICARE: NCK RADIOLOGY PA

MEDICARE: NCK RADIOLOGY PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1225024300
Entity Type Code : Organization
Provider Name (Legal Business Name) : NCK RADIOLOGY PA
Provider Business Mailing Address
First Line : PO BOX 325
Second Line :
City : CONCORDIA
State : KS
Zip : 66901-0325
Country : US
Telephone Number : 785-243-1188
Fax Number : 785-243-1151
Provider Business Practice Location Address
First Line : 400 W 8TH ST
Second Line : MITCHELL COUNTY HOSPITAL
City : BELOIT
State : KS
Zip : 67420-1605
Country : US
Telephone Number : 785-738-2266
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : RICHARD JOAN KUEKLER
Credential : MD
Telephone Number : 785-243-1188
Provider Enumeration Date : 09/23/2005
Last Update Date : 08/22/2020

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Directions to “NCK RADIOLOGY PA ” Practice Location

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