Southern Iowa Open Mri

LBN: Sports Medicine Diagnostic Center Llc
Southern Iowa Open Mri is an health care organization with primary practice located at 1005 Pennsylvania Ave Suite 201B, Ottumwa IA 52501-6413. The organization recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Magnetic Resonance Imaging, which is considered as the primary health care specialty. Sports Medicine Diagnostic Center Llc can be contacted via phone (641) 683-1113, or through Berg, Donald D via phone (641) 683-1113.

Contact Information

Primary practice address
1005 Pennsylvania Ave Suite 201B Ottumwa IA 52501-6413
Phone: (641) 683-1113
Fax: (641) 683-1114
Website:
Map and Directions
Authorized official contact:
Name: Berg, Donald D Doctor of Medicine (MD)
Phone: (641) 683-1113

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Magnetic Resonance Imaging 2471M1202X

Profile Details

NPI number 1467411793
LBN Legal business name Sports Medicine Diagnostic Center Llc
DBA Doing business as Southern Iowa Open Mri
Authorized official Berg, Donald D Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 23rd, 2006
Last updated Feb 22nd, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467411793 NPPES
Iowa MEDICAID 0210245
Iowa Other 300133842
Iowa Other 22312

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