Organization
GLASGOW RADIOLOGY, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL W SHADOWEN M.D. (PRESIDENT)
(270) 651-9129
Entity
Organization
Contact information
Practice address
106 E WAYNE ST, GLASGOW, KY 42141-2636
(270) 651-9129
(270) 651-4916
Mailing address
PO BOX 1537, GLASGOW, KY 42142-1537
(270) 651-9129
(270) 651-4916
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000057712
ANTHEM GROUP
KY
05
—
65906059
—
KY
Enumeration date
02/20/2007
Last updated
05/28/2019
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