Organization
DENALI IOM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D HAYDEN (PRESIDENT)
(270) 929-4141
Entity
Organization
Contact information
Practice address
1211 GRIFFITH AVE, OWENSBORO, KY 42301-2816
(270) 929-4141
Mailing address
1211 GRIFFITH AVE, OWENSBORO, KY 42301-2816
(270) 929-4141
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
984616
AK
Other
Enumeration date
02/11/2013
Last updated
02/11/2013
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