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Organization

KENNETT RADIOLOGY ASSOCIATES

Active
Parent organization
KENNETT HMA PHYSICIAN MANAGEMENT, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
KENNETT HMA PHYSICIAN MANAGEMENT, INC.
Authorized official
MRS. MICHELLE BEACHAM (CONTROLLER)
(573) 888-8424
Entity
Organization

Contact information

Practice address
1301 1ST ST, KENNETT, MO 63857-2525
(573) 888-8424
(573) 888-2715
Mailing address
1231 1ST ST, SUITE 8, KENNETT, MO 63857-2527
(573) 888-8424
(573) 888-2715

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R2G95
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500451901
MO
Enumeration date
07/16/2008
Last updated
07/16/2008
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