| Organization Name: | CAPITAL REGION MEDICAL CENTER |
| NPI Number: | 1679825244 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TOM LUEBBERING (VICE PRESIDENT OF FINANCE) |
| Mailing Address: | 1432 Southwest Blvd Jefferson City |
| State: | MO US |
| Postal Code: | 651092444 |
| Phone Number: | 5736325580 |
| Fax Number: | |
| NPI Enumeration Date: | 10/08/2012 |
| NPI Last Update Date: | 12/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |