Organization
TRI-STATE RADIOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM E FULCHER M.D. (OWNER)
(319) 524-7150
Entity
Organization
Contact information
Practice address
1600 MORGAN ST, KEOKUK, IA 52632-3456
(319) 524-7150
(319) 233-0722
Mailing address
PO BOX 457, KEOKUK, IA 52632-0457
(319) 526-5380
(319) 233-0722
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
05/02/2006
Last updated
07/30/2007
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