OrganizationActive
417 Sports Advanced Imaging LLC
NPI 1225906597 · Diagnostic Radiology Physician · Springfield, MO
Provider details
- NPI number
- 1225906597
- Entity type
- Organization
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Eric Gifford, Owner(417) 771-3147
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3328 S National Ave
Springfield, MO 65807-7305
Phone: (417) 771-3147
Approximate (ZIP-level) locationGet directions
Mailing address
3328 S National Ave
Springfield, MO 65807-7305
Registry dates
- Enumerated
- 2025-10-28
- Last updated
- 2025-10-28
- Certified
- 2025-10-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.