| Organization Name: | MOBERLY RADIOLOGY & IMAGING I, LLC |
| NPI Number: | 1093854358 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EMILY MCKEEN (BILLING MANAGER) |
| Mailing Address: | 1509 Union Ave Moberly |
| State: | MO US |
| Postal Code: | 652709407 |
| Phone Number: | 6602638986 |
| Fax Number: | 6602638993 |
| NPI Enumeration Date: | 02/05/2007 |
| NPI Last Update Date: | 10/03/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |