Organization
NEVADA IMAGING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T MOORE MD (OWNER)
(417) 667-3355
Entity
Organization
Contact information
Practice address
800 S ASH ST, NEVADA, MO 64772-3223
(417) 667-3355
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
(660) 826-4852
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22965012
BCBS
MO
Enumeration date
12/12/2005
Last updated
03/11/2008
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