Provider Demographics
NPI:1447551734
Name:MEDICAL IMAGING AND PROCEDURES PROF LLC
Entity type:Organization
Organization Name:MEDICAL IMAGING AND PROCEDURES PROF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:POSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-845-3606
Mailing Address - Street 1:PO BOX 1529
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-6529
Mailing Address - Country:US
Mailing Address - Phone:877-845-3606
Mailing Address - Fax:801-593-9626
Practice Address - Street 1:2601 FOX RUN PKWY
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-5341
Practice Address - Country:US
Practice Address - Phone:605-665-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD49662085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty