Organization
MISSOURI IMAGING, INC
Active
Organization
MISSOURI IMAGING, INC
Active
Other names
Kirkwood MRI & Imaging, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL J SCHAEFER (COO)
(770) 300-0101
Entity
Organization
Contact information
Practice address
473 S KIRKWOOD RD, KIRKWOOD, MO 63122-6119
(314) 821-6187
(314) 821-8937
Mailing address
PO BOX 934995, ATLANTA, GA 31193-4995
(866) 659-1211
(336) 774-1751
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194034
BC
MO
01
—
470000936
MEDICARE RR
—
05
—
717255301
—
MO
01
—
7751138
AETNA
—
Enumeration date
05/03/2006
Last updated
12/01/2009
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