Organization
NORTHEAST MISSOURI IMAGING ASSOCIATES, INC.
Active
Organization
NORTHEAST MISSOURI IMAGING ASSOCIATES, INC.
Active
Other names
Hannibal Imaging Associates, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON SELLE (ADMINISTRATOR)
(573) 221-7870
Entity
Organization
Contact information
Practice address
6000 HOSPITAL DRIVE, HANNIBAL, MO 63401
(573) 221-7870
(573) 221-9323
Mailing address
PO BOX 861, HANNIBAL, MO 63401-0861
(573) 221-7870
(573) 221-9323
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1040
ANTHEM BLUE CROSS
MO
01
—
137441
HEALTHLINK
MO
Enumeration date
05/01/2006
Last updated
09/20/2007
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