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General NPI Number Information
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NPI Number | 1497873525
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Entity Type | Organization
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Legal Business Name | PREMIER RADIOLOGY SERVICES PSC
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1801 ASHLEY CIR
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City | BOWLING GREEN
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State | KY
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Zip | 42104-3362
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Country | US
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Telephone | 800-824-2544
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8035
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City | CANTON
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State | OH
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Zip | 44711-8035
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Country | US
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Telephone | 800-824-2544
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEVIN L. BURNER
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Credential | MD
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Telephone | 800-824-2544
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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 | KY
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