# CENTRAL KENTUCKY DIAGNOSTIC CENTER, LLC

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

## Provider details

- **NPI number:** 1659702660
- **Authorized official:** MR. TIM TAYLOR ARRT RT(R) (PRESIDENT/CEO)
- **Authorized official phone:** (606) 305-3192

## Contact information

- **Practice address:** 102 AGRICULTURAL WAY, STANFORD, KY 40484-1461
- **Practice address phone:** (606) 305-3192
- **Practice address fax:** (606) 365-4888
- **Mailing address:** 102 AGRICULTURAL WAY, STANFORD, KY 40484-1461
- **Mailing address phone:** (606) 305-3192
- **Mailing address fax:** (606) 365-4888

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | KY | Yes |

## Other

- **Enumeration date:** 12/02/2013
- **Last updated:** 05/28/2015