Organization
OWENSBORO MEDICAL PRACTICE LABORATORY
Active
Parent organization
OWENSBORO MEDICAL PRACTICE
Organization subpart
Yes
Provider details
NPI number
Legal business name
OWENSBORO MEDICAL PRACTICE
Authorized official
DR. KISHOR N VORA MD,FACC,FSCAI (CEO)
(270) 683-8672
Entity
Organization
Contact information
Practice address
1200 BRECKENRIDGE ST, STE 101, OWENSBORO, KY 42303-1089
(270) 683-8672
(270) 685-8233
Mailing address
1200 BRECKENRIDGE ST, STE 101, OWENSBORO, KY 42303-1089
(270) 683-8672
(270) 685-8233
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
200274
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851315105
NPI
KY
05
—
64287535
—
KY
Enumeration date
05/28/2008
Last updated
05/28/2008
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