Organization
BLUEGRASS REGIONAL IMAGING LLC
Active
Organization
BLUEGRASS REGIONAL IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON K KOSTELIC M.D. (MEMBER)
(859) 219-0542
Entity
Organization
Contact information
Practice address
211 FOUNTAIN CT, SUITE 140, LEXINGTON, KY 40509-1888
(859) 629-7230
(859) 629-7231
Mailing address
651 PERIMETER DR STE 690, LEXINGTON, KY 40517-4356
(859) 219-0542
(859) 219-9433
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000219100
ANTHEM
KY
05
—
65935207
—
KY
Enumeration date
07/07/2008
Last updated
03/27/2026
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