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NPI 1174752356

NPI 1174752356 : KENTUCKY RIVER HBP LLC : JACKSON, KY

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General NPI Number Information
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    NPI Number           |    1174752356
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    Entity Type          |    Organization 
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    Legal Business Name  |    KENTUCKY RIVER HBP LLC 
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Dates
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    Enumeration Date     |    07/08/2009
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    Last Update Date     |    07/07/2023
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Provider Practice Location Address
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    Address Line         |    540 JETT DR 
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    City                 |    JACKSON
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    State                |    KY
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    Zip                  |    41339-9622
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    Country              |    US
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    Telephone            |    606-666-6479
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    Fax                  |    606-666-6102
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Provider Business Mailing Address
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    Address Line         |    1573 MALLORY LN STE 100 
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    City                 |    BRENTWOOD
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    State                |    TN
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    Zip                  |    37027-2895
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    Country              |    US
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    Telephone            |    152-221-1400
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    Fax                  |    615-465-3007
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Authorized Official
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    Title or Position    |    SR. DIRECTOR PHYSICIAN REV CYCLE
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    Name                 |     LAURA J FEY 
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    Credential           |    
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    Telephone            |    615-221-3641
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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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