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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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