Organization
DANVILLE PATHOLOGY ASSOCIATES PLLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD G JACKSON M.D. (PRESIDENT)
(859) 239-2220
Entity
Organization
Contact information
Practice address
217 S 3RD ST, DANVILLE, KY 40422-1823
(859) 239-2220
(859) 239-6732
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
28116
KY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
18160
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65903031
—
KY
Enumeration date
02/06/2006
Last updated
09/09/2020
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