Organization
MEMORIAL HOSPITAL, INC.
Active
Other names
Physician Services of Memorial Hospital Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
BENNY NOLEN (VICE PRESIDENT)
(606) 598-5104
Entity
Organization
Contact information
Practice address
210 MARIE LANGDON DR, MANCHESTER, KY 40962-6388
(606) 598-5104
(606) 598-0983
Mailing address
509 MEMORIAL DR, SUITE 2, MANCHESTER, KY 40962-6195
(606) 598-5104
(606) 598-0983
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65934523
—
KY
Enumeration date
12/14/2010
Last updated
01/13/2021
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