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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