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General NPI Number Information
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NPI Number | 1962492066
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Entity Type | Organization
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Legal Business Name | NORTHEAST KENTUCKY IMAGING INC
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Dates
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Enumeration Date | 10/28/2005
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 1000 SAINT CHRISTOPHER DR
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City | ASHLAND
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State | KY
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Zip | 41101-7034
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Country | US
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Telephone | 606-833-2273
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX M
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City | RUSSELL
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State | KY
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Zip | 41169-0510
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Country | US
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Telephone | 866-286-5888
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EUGENE R DEGIORGIO
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Credential | MD
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Telephone | 866-286-5888
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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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