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Organization
MIDWEST DIAGNOSTIC IMAGING CENTER
Active
Organization
MIDWEST DIAGNOSTIC IMAGING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS BOB ROSS JR. (PRESIDENT CEO)
(866) 504-2674
Entity
Organization
Contact information
Practice address
4120 LINDELL BLVD, SAINT LOUIS, MO 63108-2914
(866) 504-2674
Mailing address
3920 LINDELL BLVD, SUITE 210, SAINT LOUIS, MO 63108-3254
(866) 504-2674
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
MO
261QR0206X
Mammography Clinic/Center
—
MO
Other
Enumeration date
12/05/2007
Last updated
12/05/2007
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