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
Update your record
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