| Organization Name: | ST LUKES CENTER FOR DIAGNOSTIC IMAGING LLC |
| NPI Number: | 1932145828 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONALD D JACOBSEN (OFFICER ON THE BOARD SECRETARY) |
| Mailing Address: | 5551 Winghaven Boulevard Suite 60 Ofallon |
| State: | MO US |
| Postal Code: | 633683618 |
| Phone Number: | 6366254434 |
| Fax Number: | 6366254432 |
| NPI Enumeration Date: | 06/21/2006 |
| NPI Last Update Date: | 07/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| 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. |