Provider Demographics
NPI:1407921406
Name:WEST PLAINS IMAGING LLC
Entity type:Organization
Organization Name:WEST PLAINS IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:417-257-7451
Mailing Address - Street 1:PO BOX 707
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-0707
Mailing Address - Country:US
Mailing Address - Phone:417-257-7451
Mailing Address - Fax:417-256-9277
Practice Address - Street 1:3102 INDEPENDENCE SQUARE
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-4235
Practice Address - Country:US
Practice Address - Phone:417-257-7451
Practice Address - Fax:417-256-9277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOCD0604OtherRAILROAD MEDICARE