# LAKE REGIONAL IMAGING PARTNERS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245283290
- **Authorized official:** MR. DAVID W. HALSELL (SR. V.P., CFO/AUTHORIZED OFFICIAL)
- **Authorized official phone:** (573) 348-8388

## Contact information

- **Practice address:** 1075 NICHOLS RD, OSAGE BEACH, MO 65065-3093
- **Practice address phone:** (573) 348-6161
- **Practice address fax:** (573) 348-6162
- **Mailing address:** 1075 NICHOLS RD, OSAGE BEACH, MO 65065-3093
- **Mailing address phone:** (573) 348-6161
- **Mailing address fax:** (573) 348-6162

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | — |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |
| 261QR0206X | Mammography Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 08/19/2015