Organization
MIDWEST RADIOLOGY KENTUCKY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN GANOTE (OPERATIONS MANAGER)
(317) 557-6165
Entity
Organization
Contact information
Practice address
4500 BOWLING BLVD STE 100, LOUISVILLE, KY 40207-5147
(317) 595-6040
(317) 595-6050
Mailing address
PO BOX 56046, INDIANAPOLIS, IN 46256-0046
(317) 595-6040
(317) 595-6050
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
720176
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86000395
—
KY
01
—
P00089265
RAILROAD MEDICARE
KY
Enumeration date
02/08/2007
Last updated
02/19/2008
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