MEDICARE: JAIME HARKER RDMS, RVT, RDCS, RTR

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
1	2471S1302X	Sonography Radiologic Technologist	115968	MO

General Provider Information

NPI Number	:	1770476681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIME HARKER RDMS, RVT, RDCS, RTR

Provider Business Mailing Address
First Line	:	3401 COUNTY LINE RD
Second Line	:
City	:	MOUNTAIN GROVE
State	:	MO
Zip	:	65711-2714
Country	:	US
Telephone Number	:	417-926-8078
Fax Number	:

Provider Business Practice Location Address
First Line	:	705 N MAIN ST
Second Line	:
City	:	MOUNTAIN GROVE
State	:	MO
Zip	:	65711-1312
Country	:	US
Telephone Number	:	417-926-8078
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2025
Last Update Date	:	05/30/2025

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