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General NPI Number Information
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NPI Number | 1891158119
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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 | 04/04/2016
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Last Update Date | 12/28/2022
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Provider Practice Location Address
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Address Line | 420 HOPKINSVILLE ST
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City | GREENVILLE
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State | KY
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Zip | 42345-1102
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Country | US
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Telephone | 270-377-2405
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Fax | 270-377-2406
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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 | MR. RUSSELL S RANALLO
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Credential |
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Telephone | 270-417-4813
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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 | 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 #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology 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 | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine 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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery 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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #8
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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 #9
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #10
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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 | KY
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Taxonomy #11
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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 #12
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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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