Organization
PROFESSIONAL MRI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN HOMER MCQUAIDE M.D. (PRESIDENT)
(859) 623-8823
Entity
Organization
Contact information
Practice address
803 EASTERN BYP, RICHMOND, KY 40475-2751
(859) 623-8823
(859) 623-8810
Mailing address
PO BOX 1429, FRANKFORT, KY 40602-1429
(502) 226-3858
(502) 223-9829
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000310923
ANTHEM GROUP PIN
KY
05
—
65939126
—
KY
Enumeration date
07/15/2006
Last updated
08/22/2020
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