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Contact Information

MARYVILLE RADIOLOGY GROUP, LTD
ILLINOIS ROUTE 162
ANDERSON HOSPITAL DEPT OF RADIOLOGY
MARYVILLE, IL62062
 Phone: 618-288-5711
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for MARYVILLE RADIOLOGY GROUP, LTD

NPI Number 1497773063
LBN Legal business name MARYVILLE RADIOLOGY GROUP, LTD
Authorized official TERRY BURK - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/18/2006
Last updated 02/12/2020 - About 6 years ago
Identifiers
Other 99693 GHP
IL Other 6010052 BCBS
MO Other 149856 BCBS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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