Organization
MIDWEST RADIOLOGY AND IMAGING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES ALLEN CROUCH M.D. (PHYSICIAN/OWNER)
(712) 262-7511
Entity
Organization
Contact information
Practice address
1200 1ST AVE E, SPENCER, IA 51301-4342
(712) 262-7511
(712) 262-3658
Mailing address
1200 1ST AVE E, SPENCER, IA 51301-4342
(712) 262-7511
(712) 262-3658
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN6278
RAILROAD MEDICARE
IA
Enumeration date
05/24/2005
Last updated
08/31/2009
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