Independent Imaging, LLC

Organization Active NPI Diagnostic Radiology Physician · Aurora, MO

NPI 1265583462 · NPPES record last updated Apr 11, 2008

Key facts

NPI
1265583462
Entity type
Organization (NPI type 2)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
License
LC0773278 (MO)
Legal business name
INDEPENDENT IMAGING, LLC
Practice address
500 Porter Ave
Aurora, MO 65605-2365
Phone
(417) 678-7880
NPI assigned
Jan 15, 2007
Organization subpart
No

Authorized official

Name
Mr. Jeffrey L Shore, MD
Title
President
Phone
(314) 821-5600

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
2085R0202X LC0773278 MO Yes

Addresses

Primary practice location

500 Porter Ave
Aurora, MO 65605-2365

Mailing address

1715 Deer Tracks TRL
Suite 130
Saint Louis, MO 63131-1839
Phone (314) 821-5600

Other providers in Aurora, MO

All providers in Aurora, MO · Diagnostic Radiology Physician in Missouri

Sources for this page

Verify at the official NPI Registry.