Healthcare Provider Details

I. General information

NPI: 1952350761
Provider Name (Legal Business Name): CENTRAL KENTUCKY RADIOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 PERIMETER DR STE 690
LEXINGTON KY
40517-4356
US

IV. Provider business mailing address

651 PERIMETER DR STE 390
LEXINGTON KY
40517-4134
US

V. Phone/Fax

Practice location:
  • Phone: 859-219-0542
  • Fax: 859-219-9433
Mailing address:
  • Phone: 859-219-0542
  • Fax: 859-219-9433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIE COFFEY
Title or Position: CEO
Credential:
Phone: 859-219-0542