Organization
INTERVENTIONAL PROCEDURES GROUP LTD
Active
Other names
Center for Diagnostic Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD D JACOBSEN (OFFICER ON THE BOARD SECRETARY)
(952) 543-6500
Entity
Organization
Contact information
Practice address
2445 NORTH MAYFAIR ROAD, WAUWATOSA, WI 53226
(414) 774-7226
(414) 774-6004
Mailing address
5775 WAYZATA BLVD., SUITE 400, ST. LOUIS PARK, MN 55416
(952) 542-8553
(952) 513-6880
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
05/18/2006
Last updated
04/02/2008
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