Organization
GREAT PLAINS RADIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD RENE HABERT M.D. (DIRECTOR)
(314) 822-0690
Entity
Organization
Contact information
Practice address
12639 OLD TESSON RD, SUITE 115, SAINT LOUIS, MO 63128-2786
(314) 842-8655
(314) 842-2972
Mailing address
125 E CLINTON PL APT 2A, KIRKWOOD, MO 63122-6172
(314) 822-0690
(314) 842-2972
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
04/06/2007
Last updated
08/22/2020
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