Organization
MEDICAL IMAGING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY WAGNER CPC, RCC (CODING SPECIALIST)
(816) 455-0661
Entity
Organization
Contact information
Practice address
15943 W 65TH ST, SHAWNEE, KS 66217-9342
(816) 455-0661
(816) 455-3905
Mailing address
9501 N OAK TRFY STE 100, KANSAS CITY, MO 64155-2201
(816) 455-0661
(816) 455-3905
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07119026
BCBS
KS
Enumeration date
05/30/2007
Last updated
03/18/2008
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