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Organization

PIKEVILLE RADIOLOGY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALEXANDER POULOS MD (MEMBER)
(606) 432-1357
Entity
Organization

Contact information

Practice address
911 SOUTH BYPASS ROAD, PIKEVILLE, KY 41501
(606) 432-1357
(606) 432-2457
Mailing address
PO BOX 2648, PIKEVILLE, KY 41502
(606) 432-1357
(606) 432-2457

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0958131
UMWA
01
163435400
FEDERAL BLACK LUNG
05
65932626
KY
05
7100239770
KY
01
CB5786
PALMETTO GBA RR MEDICARE
KY
Enumeration date
08/29/2006
Last updated
06/06/2013
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