Provider Demographics
NPI:1760842603
Name:MISSOURI DIAGNOSTIC SERVICES, LLC
Entity Type:Organization
Organization Name:MISSOURI DIAGNOSTIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY / MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-207-0031
Mailing Address - Street 1:1517 COPPER RD
Mailing Address - Street 2:
Mailing Address - City:HOLTS SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:65043-2033
Mailing Address - Country:US
Mailing Address - Phone:660-207-0031
Mailing Address - Fax:877-673-5233
Practice Address - Street 1:1517 COPPER RD
Practice Address - Street 2:
Practice Address - City:HOLTS SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:65043-2033
Practice Address - Country:US
Practice Address - Phone:660-207-0031
Practice Address - Fax:877-673-5233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty