Dr RODERICK JACK WILLMORE is a male medical professional, specializing in Diagnostic Radiology. He graduated in 2011 from Medical College Of Virginia Commonwealth University School Of Medicine.
MEDICAL IMAGING ASSOC OF IDAHO FALLS PA
2221 ELM ST
RAWLINS
WY
823015108
Tel: 3073248381
| Npi | 1346538253 |
| Pac Id | 5597997379 |
| Professional Enrollment Id | I20170602000855 |
| Last Name | WILLMORE |
| First Name | RODERICK |
| Middle Name | JACK |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | MEDICAL COLLEGE OF VIRGINIA COMMONWEALTH UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2011 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | MEDICAL IMAGING ASSOC OF IDAHO FALLS PA |
| Group Practice Pac Id | 7618876590 |
| Number Of Group Practice Members | 32 |
| Line 1 Street Address | 2221 ELM ST |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | RAWLINS |
| State | WY |
| Zip Code | 823015108 |
| Phone Number | 3073248381 |
| Hospital Affiliation Ccn 1 | 130018 |
| Hospital Affiliation Lbn 1 | EASTERN IDAHO REGIONAL MEDICAL CENTER |
| Hospital Affiliation Ccn 2 | 130065 |
| Hospital Affiliation Lbn 2 | MOUNTAIN VIEW HOSPITAL |
| Hospital Affiliation Ccn 3 | 130028 |
| Hospital Affiliation Lbn 3 | PORTNEUF MEDICAL CENTER |
| Hospital Affiliation Ccn 4 | 130025 |
| Hospital Affiliation Lbn 4 | MADISON MEMORIAL HOSPITAL |
| Hospital Affiliation Ccn 5 | 131314 |
| Hospital Affiliation Lbn 5 | SHOSHONE MEDICAL CENTER |
| Professional Accepts Medicare Assignment | Y |
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