Organization
MAYSVILLE DIAGNOSTIC CENTER SLEEP LAB
Active
Parent organization
MAYSVILLE DIAGNOSTIC CENTER LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAYSVILLE DIAGNOSTIC CENTER LLC
Authorized official
JEFF W FRITZ (DIRECTOR)
(606) 759-9353
Entity
Organization
Contact information
Practice address
901 KENTON STATION DR, MAYSVILLE, KY 41056-9609
(606) 759-0073
(606) 759-0075
Mailing address
910 KENTON STATION DR, SUITE E, MAYSVILLE, KY 41056-9658
(606) 759-0073
(606) 759-0075
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
730122
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000555662
ANTHEM
KY
Enumeration date
06/19/2008
Last updated
06/24/2008
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