# MIRAGE IMAGING LLC

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

## Provider details

- **NPI number:** 1992729487
- **Authorized official:** GORDON FUNK (CEO)
- **Authorized official phone:** (620) 663-4800

## Contact information

- **Practice address:** 1818 E 23RD AVE, HUTCHINSON, KS 67502-1106
- **Practice address phone:** (620) 663-4800
- **Practice address fax:** (620) 663-4803
- **Mailing address:** 1818 E 23RD AVE, HUTCHINSON, KS 67502-1106
- **Mailing address phone:** (620) 663-4800
- **Mailing address fax:** (620) 663-4803

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/27/2006
- **Last updated:** 08/22/2020