Organization
SOUTH COUNTY PET IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY B JUDD M.D. (DIRECTOR OF RADIOLOGY)
(314) 525-1748
Entity
Organization
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-1748
(314) 525-1849
Mailing address
PO BOX 843840, KANSAS CITY, MO 64184-3840
(314) 821-8055
(314) 821-1833
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122078
GHP
—
01
—
154920
BCBS
MO
01
—
1601756
UHC
—
Enumeration date
12/13/2005
Last updated
07/21/2022
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