Organization
CENTRAL KENTUCKY DIAGNOSTIC CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM TAYLOR ARRT RT(R) (PRESIDENT/CEO)
(606) 305-3192
Entity
Organization
Contact information
Practice address
102 AGRICULTURAL WAY, STANFORD, KY 40484-1461
(606) 305-3192
(606) 365-4888
Mailing address
102 AGRICULTURAL WAY, STANFORD, KY 40484-1461
(606) 305-3192
(606) 365-4888
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100338650
—
KY
01
—
730228
STATE LICENSE
KY
Enumeration date
12/02/2013
Last updated
05/28/2015
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