Provider Demographics
NPI:1003017575
Name:MEDICAL IMAGING INC
Entity Type:Organization
Organization Name:MEDICAL IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CODING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, RCC
Authorized Official - Phone:816-455-0661
Mailing Address - Street 1:9501 N OAK TRFY STE 100
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2201
Mailing Address - Country:US
Mailing Address - Phone:816-455-0661
Mailing Address - Fax:816-455-3905
Practice Address - Street 1:19000 E EASTLAND CENTER CT STE 100
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-7023
Practice Address - Country:US
Practice Address - Phone:816-876-2900
Practice Address - Fax:816-876-2903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO07119026OtherBCBS