Organization
MEDICAL IMAGING, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN S. DYKSTRA DO (PHYSICIAN/PARTNER)
(816) 455-0661
Entity
Organization
Contact information
Practice address
9501 N. OAK TRFY, KANSAS CITY, MO 64155-2256
(816) 795-6179
Mailing address
PO BOX 414975, KANSAS CITY, MO 64141-4975
(913) 642-4900
(913) 381-3454
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0711198002
—
MO
01
—
07119026
BCBS
MO
Enumeration date
02/21/2007
Last updated
02/01/2010
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