# OWENSBORO HEALTH MEDICAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OWENSBORO HEALTH, INC
- **Other names:** Owensboro Health Mobile Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1861248502
- **Legal business name:** OWENSBORO HEALTH, INC
- **Authorized official:** RUSSELL S. RANALLO (SECRETARY-CFO)
- **Authorized official phone:** (270) 685-7180

## Contact information

- **Practice address:** 811 E PARRISH AVE STE 102-B, OWENSBORO, KY 42303-3258
- **Practice address phone:** (270) 688-1009
- **Practice address fax:** (270) 688-1010
- **Mailing address:** PO BOX 23229, OWENSBORO, KY 42304-3229
- **Mailing address phone:** (270) 688-1330
- **Mailing address fax:** (270) 688-1338

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/24/2024
- **Last updated:** 09/09/2024