Organization
OWENSBORO HEALTH MEDICAL GROUP, INC
Active
Parent organization
OWENSBORO HEALTH, INC
Other names
Owensboro Health Medical Group - Plastic and Reconstructive Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
OWENSBORO HEALTH, INC
Authorized official
RUSSELL S RANALLO (SECRETARY)
(270) 417-4813
Entity
Organization
Contact information
Practice address
2211 MAYFAIR DR STE 305, OWENSBORO, KY 42301-4572
(270) 688-3700
(270) 688-3709
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 688-1330
(270) 688-1338
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
KY
2086S0122X
Plastic and Reconstructive Surgery Physician
—
KY
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
06/05/2014
Last updated
06/07/2023
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