St Lukes Center for Diagnostic Imaging LLC
Organization Active NPI Diagnostic Radiology Physician · Ofallon, MO
NPI 1932145828 · NPPES record last updated Jul 21, 2008
Key facts
- NPI
- 1932145828
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- ST LUKES CENTER FOR DIAGNOSTIC IMAGING LLC
- Practice address
- 5551 Winghaven Boulevard
Suite 60
Ofallon, MO 63368-3618 - Phone
- (636) 625-4434
- Fax
- (636) 625-4432
- NPI assigned
- Jun 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Donald D Jacobsen
- Title
- Officer on the Board Secretary
- Phone
- (952) 543-6500
Corporate family (same tax ID) 3
National Provider Directory
- Tax ID family
- St Lukes Center for Diagnostic Imaging LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
5551 Winghaven Boulevard
Suite 60
Ofallon, MO 63368-3618
Mailing address
PO Box 790120
St Louis, MO 63179-0120
Phone (952) 542-8553
Other providers in Ofallon, MO
- Rajiv Sadana
- Beverly Dawn Schneider
- Laura Michelle Sibley
- Lillie L Smith
- Spectrum Monitoring, LLC
- George P. Stachecki
- Dipali D Thakker
- Total Access Urgent Care, PC
- Maryann L Udy
- Shirley Joyce Vandiver
All providers in Ofallon, MO · Diagnostic Radiology Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.