Organization
KENTUCKY MOUNTAIN IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL D ELLIS MD (PRESIDENT)
(866) 457-9896
Entity
Organization
Contact information
Practice address
145 CITIZENS LN, STE B, HAZARD, KY 41701-1320
(866) 457-9896
Mailing address
PO BOX 6070, DALTON, GA 30722-6070
(866) 457-9896
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
39706
KY
Other
Enumeration date
09/22/2008
Last updated
09/22/2008
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