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General NPI Number Information
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NPI Number | 1598798258
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Entity Type | Organization
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Legal Business Name | ELIZABETHTOWN RADIOLOGY, P.S.C.
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 913 N DIXIE AVE
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-2503
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Country | US
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Telephone | 270-706-1645
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Fax | 270-706-1058
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Provider Business Mailing Address
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Address Line | 914 N DIXIE AVE SUITE 102
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-2520
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Country | US
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Telephone | 270-765-4144
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Fax | 270-765-5458
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | KAREN WILLIAMS
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Credential | M.D.
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Telephone | 270-706-1650
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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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