Organization
SOUTH COUNTY RADIOLOGISTS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY B JUDD M.D. (DIRECTOR OF RADIOLOGY)
(314) 525-4492
Entity
Organization
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-4492
(314) 525-4481
Mailing address
PO BOX 954129, SAINT LOUIS, MO 63195-4129
(314) 821-8055
(314) 821-1833
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
MO
2085N0700X
Neuroradiology Physician
—
MO
2085N0904X
Nuclear Radiology Physician
—
MO
2085R0202X
Diagnostic Radiology Physician
Primary
—
MO
2085R0204X
Vascular & Interventional Radiology Physician
—
MO
2085U0001X
Diagnostic Ultrasound Physician
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112315
HEALTHLINK
—
01
—
1765
BCBS
MO
01
—
4964V4964
GHP
—
01
—
CR0296
TRAVELERS
—
Enumeration date
12/05/2005
Last updated
04/20/2008
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