Organization
DIAGNOSTIC RADIOLOGY SYSTEMS
Active
Other names
KENTUCKY METABOLIC IMAGING
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE MANOR (PRESIDENT)
(859) 231-7644
Entity
Organization
Contact information
Practice address
2425 REGENCY RD, LEXINGTON, KY 40503-2948
(859) 275-2100
(859) 275-1159
Mailing address
601 W SHORT ST, LEXINGTON, KY 40508-1246
(859) 231-7644
(859) 233-7644
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
730053
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000073108
ANTHEM PIN
KY
01
—
1167041
CHA PIN
KY
01
—
1600375
UHC PIN
KY
01
—
5864584
AETNA PIN
KY
01
—
6755
BGFH
KY
05
—
86030343
—
KY
Enumeration date
05/23/2006
Last updated
08/22/2020
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