| Organization Name: | POPLAR BLUFF RADIOLOGY SERVICES INC |
| NPI Number: | 1073793642 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIMBERLY MCVEY (SECRETARY/TREASURER) |
| Mailing Address: | 1720 Kanell Blvd Suite1 Poplar Bluff |
| State: | MO US |
| Postal Code: | 639014009 |
| Phone Number: | 5737781336 |
| Fax Number: | 5737781336 |
| NPI Enumeration Date: | 11/12/2007 |
| NPI Last Update Date: | 10/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | R4N69 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |