Provider Demographics
NPI:1255391447
Name:MEDICAL IMAGING PHYSICIANS, L.L.P.
Entity type:Organization
Organization Name:MEDICAL IMAGING PHYSICIANS, L.L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:LUEBBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:712-279-3285
Mailing Address - Street 1:4200 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5945
Mailing Address - Country:US
Mailing Address - Phone:515-226-7426
Mailing Address - Fax:
Practice Address - Street 1:2720 STONE PARK BLVD
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3734
Practice Address - Country:US
Practice Address - Phone:712-279-3285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0459768Medicaid
25836OtherBCBS OF IOWA
35837OtherBCBS OF IOWA
CH4175OtherRAILROAD MEDICARE
IA0459768Medicaid
IA0459768Medicaid