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General NPI Number Information
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NPI Number | 1962624064
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Entity Type | Organization
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Legal Business Name | CUMBERLAND RADIOLOGY PSC
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 12/10/2007
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Provider Practice Location Address
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Address Line | 145 PERCIFUL ST
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City | MOUNT VERNON
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State | KY
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Zip | 40456-2740
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Country | US
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Telephone | 706-226-6806
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Fax | 706-226-6806
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Provider Business Mailing Address
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Address Line | PO BOX 1270
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City | MOUNT VERNON
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State | KY
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Zip | 40456-1270
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Country | US
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Telephone | 706-226-6806
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Fax | 706-226-6806
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Authorized Official
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Title or Position | PRES
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Name | DR. WILLIAM DONALD DOOLEY
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Credential | M. D.
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Telephone | 606-256-4208
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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 | 25769
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License Number State | KY
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