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General NPI Number Information
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NPI Number | 1447259197
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Entity Type | Organization
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Legal Business Name | MAYSVILLE RADIOLOGY ASSOCIATES, PSC
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 07/01/2014
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Provider Practice Location Address
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Address Line | 989 MEDICAL PARK DR
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City | MAYSVILLE
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State | KY
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Zip | 41056-8750
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Country | US
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Telephone | 606-759-3130
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Fax | 502-223-9829
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Provider Business Mailing Address
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Address Line | PO BOX 813
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City | MAYSVILLE
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State | KY
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Zip | 41056-0813
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Country | US
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Telephone | 606-759-3130
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Fax | 502-223-9829
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD S HARTMAN
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Credential | MD
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Telephone | 606-759-3130
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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 | 19217
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License Number State | KY
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