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Organization

SCOTT RADIOLOGICAL GROUP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES A JUNKER M. D. (PRESIDENT AND CEO)
(314) 647-2344
Entity
Organization

Contact information

Practice address
1420 HIGHWAY 61 SOUTH, FESTUS, MO 63028-4108
(314) 647-2344
(314) 647-5108
Mailing address
2344 HAMPTON AVE, SAINT LOUIS, MO 63139-2909
(314) 647-2344
(314) 647-5108

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
194361
BLUE CROSS BLUE SHIELD
MO
01
27716V27716
GROUP HEALTH PLAN
MO
05
500875703
MO
01
CP4241
RAILROAD MEDICARE
MO
Enumeration date
07/10/2006
Last updated
08/25/2009
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