Organization
MIDWEST RADIOLOGICAL ASSOCIATES PC
Active
Organization
MIDWEST RADIOLOGICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THORNTON MD (PRESIDENT)
(314) 548-4715
Entity
Organization
Contact information
Practice address
3015 N BALLAS ROAD, MISSOURI BAPTIST MEDICAL CENTER, ST LOUIS, MO 63131
(314) 548-4715
(314) 821-2180
Mailing address
13209 CORPORATE EXCHANGE DR, BRIDGETON, MO 63044-3721
(314) 548-4715
(866) 302-5278
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
12444
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
508154606
MCAID
IL
05
—
508154606
—
MO
01
—
90000352
BLUE SHIELD
—
Enumeration date
07/13/2006
Last updated
04/20/2020
Update your record
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