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General NPI Number Information
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NPI Number | 1043314693
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Entity Type | Organization
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Legal Business Name | X-RAY ASSOCIATES
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 1211 N MAIN ST OHIO COUNTY HOSPITAL
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City | HARTFORD
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State | KY
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Zip | 42347
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Country | US
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Telephone | 270-685-5165
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Fax | 270-683-0256
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Provider Business Mailing Address
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Address Line | PO BOX 807 X-RAY ASSOCIATES
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City | OWENSBORO
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State | KY
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Zip | 42302-0807
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Country | US
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Telephone | 270-685-5165
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Fax | 270-683-0256
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Authorized Official
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Title or Position | PRESIDENT MEMBER
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Name | FREDERIC C PARK
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Credential | MD
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Telephone | 270-685-5165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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