# OWENSBORO HEALTH MEDICAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Owensboro Health Medical Group - Family Medicine Residency
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346710167
- **Authorized official:** RUSSELL S RANALLO (SECRETARY)
- **Authorized official phone:** (270) 691-8022

## Contact information

- **Practice address:** 811 E PARRISH AVE STE 102, OWENSBORO, KY 42303-3258
- **Practice address phone:** (270) 688-2077
- **Practice address fax:** (270) 688-2078
- **Mailing address:** PO BOX 23229, OWENSBORO, KY 42304-3229
- **Mailing address phone:** (270) 691-8070
- **Mailing address fax:** (270) 691-8026

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/05/2018
- **Last updated:** 03/19/2024