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General NPI Number Information
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NPI Number | 1740144260
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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 | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 912 WALLACE AVE STE 104
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City | LEITCHFIELD
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State | KY
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Zip | 42754-2405
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Country | US
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Telephone | 270-287-0001
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Fax | 270-287-0005
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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 | 270-691-8070
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Fax |
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Authorized Official
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Title or Position | SECRETARY/CFO
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Name | RUSS 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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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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 | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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