Organization
EASTERN KENTUCKY IMAGING, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP N ZAMBOS MD (OWNER)
(606) 836-4929
Entity
Organization
Contact information
Practice address
5000 KY RT 321, RADIOLOGY DEPARTMENT, PRESTONSBURG, KY 41653-9113
(606) 836-4929
(606) 836-3185
Mailing address
PO BOX 148, ASHLAND, KY 41105-0148
(606) 836-4929
(606) 836-3185
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25854
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000332784
ANTHEM BLUE SHIELD
KY
05
—
65941494
—
KY
01
—
7200028000
WEST VIRGINIA MEDICAID
WV
Enumeration date
05/03/2007
Last updated
08/22/2020
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