Organization
KENTUCKIANA RADIOLOGY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA BOWYER (PRESIDENT)
(502) 876-6644
Entity
Organization
Contact information
Practice address
858 S PENN AVE, SELLERSBURG, IN 47172-1627
(502) 363-1202
(812) 246-4063
Mailing address
PO BOX 4489, JEFFERSONVILLE, IN 47131-4489
(502) 363-1202
(812) 246-4063
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
720043
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100406310A
—
IN
05
—
86011061
—
KY
Enumeration date
05/18/2007
Last updated
02/01/2012
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