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General NPI Number Information
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NPI Number | 1376594242
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Entity Type | Organization
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Legal Business Name | OWENSBORO HEALTH MEDICAL GROUP, INC
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 2211 MAYFAIR DR STE 101
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City | OWENSBORO
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State | KY
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Zip | 42301
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Country | US
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Telephone | 270-688-1352
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Fax | 270-683-4313
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Provider Business Mailing Address
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Address Line | PO BOX 23229
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City | OWENSBORO
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State | KY
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Zip | 42304-3229
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Country | US
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Telephone | 270-688-1330
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Fax | 270-688-1338
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Authorized Official
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Title or Position | SECRETARY
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Name | RUSSELL S RANALLO
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Credential |
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Telephone | 270-685-7180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State | KY
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Taxonomy #6
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State | KY
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Taxonomy #7
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State | KY
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Taxonomy #8
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State | KY
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Taxonomy #9
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State | KY
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Taxonomy #10
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | KY
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Taxonomy #11
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State | KY
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Taxonomy #12
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | KY
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Taxonomy #13
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | KY
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Taxonomy #15
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | KY
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