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NPI Code Detail

MEDICARE: ZUBRES RADIOLOGY INC

MEDICARE: ZUBRES RADIOLOGY INC
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
12085U0001XDiagnostic Ultrasound Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000015665OTHERMEDICARE ID
4DN3307OTHERMORAILROAD MEDICARE
5P00254931OTHERMORAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
21198060OTHERFIRST HEALTH
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
61191801OTHERMOBCBS OF MO
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8211107OTHERHEALTHLINK INC

General Provider Information

NPI Number : 1679550784
Entity Type Code : Organization
Provider Name (Legal Business Name) : ZUBRES RADIOLOGY INC
Provider Business Mailing Address
First Line : PO BOX 459
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63902-0459
Country : US
Telephone Number : 573-222-7441
Fax Number : 573-222-7479
Provider Business Practice Location Address
First Line : 221 PHYSICIANS PARK
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63901-3956
Country : US
Telephone Number : 573-727-9080
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. MARK ZUBRES
Credential :
Telephone Number : 573-222-7441
Provider Enumeration Date : 12/29/2005
Last Update Date : 09/23/2008

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Directions to “ZUBRES RADIOLOGY INC ” Practice Location

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