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Alex Loiland Pederson

Radiology

Allopathic & Osteopathic Physicians

One Hospital Dr, Columbia, MO 65212-0001

PECOS Enrollment

This provider is enrolled in PECOS as ALEX PEDERSON.

Based on the most recent information from CMS, provider Alex Loiland Pederson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1083143192
Provider Type
Individual
Full Name
Pederson, Alex Loiland
Credential
DO

Gender
Male
Sole Proprietor
No
Enumeration Date
6/12/2017
Last Updated
10/4/2022

Contact Information

Practice Location

One Hospital Dr, Columbia, MO 65212-0001

(573) 884-4082

(573) 884-6661

Mailing Location

PO Box 843966, Kansas City, MO 64184-3966

(573) 884-3300

(573) 884-0943

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License 2022037576 Missouri

Alex Loiland Pederson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Robertson, Quayd

Cleek, John

Koolwal, Juhi

Pringle, Lauren Clough

Thimmappa, Nanda Deepa

Frederick, Benjamin Keith

Aro, Michael Rantiolu

George, Verghese

Wissman, Robert David

Alqudah, Abdallah Ahmad Ali