Healthcare Provider Details

I. General information

NPI: 1871706531
Provider Name (Legal Business Name): SAFEGUARD RADIOLOGY INTERPRETATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6304 THOMAS CT
PROSPECT KY
40059-7515
US

IV. Provider business mailing address

9462 BROWNSBORO RD # 268
LOUISVILLE KY
40241-1118
US

V. Phone/Fax

Practice location:
  • Phone: 502-961-0011
  • Fax: 502-213-0820
Mailing address:
  • Phone: 502-961-0111
  • Fax: 502-427-7797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number4777
License Number StateKY

VIII. Authorized Official

Name: DR. BROOKE L GAJESKI
Title or Position: OWNER
Credential: D.C.
Phone: 502-387-5133