Healthcare Provider Details

I. General information

NPI: 1124092721
Provider Name (Legal Business Name): CENTRAL KENTUCKY COMPREHENSIVE IMAGING AND DIAGNOSTIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 CHURCH ST
PIKEVILLE KY
41501-3217
US

IV. Provider business mailing address

PO BOX 697
HAZARD KY
41702-0697
US

V. Phone/Fax

Practice location:
  • Phone: 606-437-2200
  • Fax: 606-437-2450
Mailing address:
  • Phone: 606-439-2662
  • Fax: 606-439-0612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ASHOK PATEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 606-437-2200