# DENALI IOM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215276282
- **Authorized official:** JOHN D HAYDEN (PRESIDENT)
- **Authorized official phone:** (270) 929-4141

## Contact information

- **Practice address:** 1211 GRIFFITH AVE, OWENSBORO, KY 42301-2816
- **Practice address phone:** (270) 929-4141
- **Mailing address:** 1211 GRIFFITH AVE, OWENSBORO, KY 42301-2816
- **Mailing address phone:** (270) 929-4141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 984616 | AK | Yes |

## Other

- **Enumeration date:** 02/11/2013
- **Last updated:** 02/11/2013