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General NPI Number Information
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NPI Number | 1992876981
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Entity Type | Organization
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Legal Business Name | KENTUCKY IMAGING GROUP
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 05/12/2011
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Provider Practice Location Address
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Address Line | 3475 RICHMOND RD SUITE #150
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City | LEXINGTON
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State | KY
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Zip | 40509-2500
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Country | US
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Telephone | 859-275-2100
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Fax | 859-275-1159
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Provider Business Mailing Address
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Address Line | 3475 RICHMOND RD SUITE #150
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City | LEXINGTON
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State | KY
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Zip | 40509-2500
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Country | US
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Telephone | 859-275-2100
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Fax | 859-275-1159
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Authorized Official
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Title or Position | OWNER, MEDICAL DIRECTOR,RADIOLOGIST
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Name | CARINA LAWSON BUTLER
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Credential | MD
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Telephone | 859-275-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 730053
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License Number State | KY
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