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NPI Code Detail

MEDICARE: ST CLAIRE REGIONAL RADIOLOGY PHYSICIANS SERVICES

MEDICARE: ST CLAIRE REGIONAL RADIOLOGY PHYSICIANS SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000341147OTHEROHBC/BS GROUP PIN NUMBER

General Provider Information

NPI Number : 1710987508
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST CLAIRE REGIONAL RADIOLOGY PHYSICIANS SERVICES
Provider Business Mailing Address
First Line : PO BOX 766
Second Line :
City : MOREHEAD
State : KY
Zip : 40351-0766
Country : US
Telephone Number : 866-871-7657
Fax Number :
Provider Business Practice Location Address
First Line : 222 MEDICAL CIR
Second Line :
City : MOREHEAD
State : KY
Zip : 40351-1179
Country : US
Telephone Number : 606-783-6500
Fax Number :
Authorized Official
Title or Position : CEO
Name : DONALD H LLOYD II
Credential :
Telephone Number : 606-783-6502
Provider Enumeration Date : 07/22/2005
Last Update Date : 08/17/2023

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Directions to “ST CLAIRE REGIONAL RADIOLOGY PHYSICIANS SERVICES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.