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Organization

PET CT MANAGEMENT LLC

Active
Other names
BODY SCAN OF LOUISVILLE LLC
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES ALLEN MORRIS (TREASURER)
(502) 896-7672
Entity
Organization

Contact information

Practice address
7807 SHELBYVILLE RD, STE 201, LOUISVILLE, KY 40222-5439
(502) 412-2725
(502) 412-2729
Mailing address
7807 SHELBYVILLE RD, STE 201, LOUISVILLE, KY 40222-5439
(502) 412-2725
(502) 412-2729

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000321134
ANTHEM
KY
05
86000429
KY
Enumeration date
09/01/2005
Last updated
07/15/2008
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