Organization
CT AND OPEN MRI LAGRANGE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANNICE OWENS AARON M.D. (PRESIDENT)
(502) 222-3281
Entity
Organization
Contact information
Practice address
120 E ADAMS ST, SUITE 4, LA GRANGE, KY 40031-1278
(502) 222-3281
(502) 225-5796
Mailing address
120 E ADAMS ST, SUITE 4, LA GRANGE, KY 40031-1278
(502) 222-3281
(502) 225-5796
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65937781
—
KY
01
—
CK2568
RAILROAD MEDICARE GROUP
KY
Enumeration date
01/05/2006
Last updated
10/31/2007
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