| Organization Name: | LAKE REGIONAL IMAGING PARTNERS, LLC |
| NPI Number: | 1245283290 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID W. HALSELL (SR. V.P., CFO/AUTHORIZED OFFICIAL) |
| Mailing Address: | 1075 Nichols Rd Osage Beach |
| State: | MO US |
| Postal Code: | 650653093 |
| Phone Number: | 5733486161 |
| Fax Number: | 5733486162 |
| NPI Enumeration Date: | 05/19/2006 |
| NPI Last Update Date: | 08/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Magnetic Resonance Imaging (MRI) |
| Taxonomy Definition: | |