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Organization

SPRINGFIELD RADIOLOGY ASSOCIATES, PC

Active
Other names
IMAGING CONSULTANTS OF KENTUCKY
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM J. BRANNICK MD (PRESIDENT)
(931) 647-5034
Entity
Organization

Contact information

Practice address
250 PARK STREET, BOWLING GREEN, KY 42101-1760
(270) 796-6500
Mailing address
PO BOX 3125, CLARKSVILLE, TN 37043-3125
(931) 647-5034
(931) 552-6663

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000269735
ANTHEM BCBS
KY
01
020289899
DEPT. OF LABOR
05
3375149
TN
01
4042327
BCBS OF TN
TN
05
65940595
KY
01
7916327
AETNA
01
CJ8639
RR MEDICARE
TN
01
DO0012
RR MEDICARE
KY
Enumeration date
01/10/2006
Last updated
09/16/2013
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