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General NPI Number Information
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NPI Number | 1952395238
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Entity Type | Organization
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Legal Business Name | PET CT MANAGEMENT LLC
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Dates
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Enumeration Date | 09/01/2005
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 7807 SHELBYVILLE RD STE 201
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City | LOUISVILLE
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State | KY
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Zip | 40222-5439
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Country | US
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Telephone | 502-412-2725
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Fax | 502-412-2729
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Provider Business Mailing Address
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Address Line | 7807 SHELBYVILLE RD STE 201
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City | LOUISVILLE
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State | KY
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Zip | 40222-5439
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Country | US
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Telephone | 502-412-2725
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Fax | 502-412-2729
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Authorized Official
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Title or Position | TREASURER
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Name | JAMES ALLEN MORRIS
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Credential |
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Telephone | 502-896-7672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number |
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License Number State | KY
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