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NPI Code Detail

MEDICARE: BLUEGRASS BREAST IMAGING PLLC

MEDICARE: BLUEGRASS BREAST IMAGING PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427075209
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUEGRASS BREAST IMAGING PLLC
Provider Business Mailing Address
First Line : 1218 S BROADWAY
Second Line : SUITE 310
City : LEXINGTON
State : KY
Zip : 40504-2759
Country : US
Telephone Number : 859-219-0542
Fax Number : 859-219-9433
Provider Business Practice Location Address
First Line : 160 N EAGLE CREEK DR
Second Line : STE 101
City : LEXINGTON
State : KY
Zip : 40509-2121
Country : US
Telephone Number : 859-967-5613
Fax Number : 859-967-5617
Authorized Official
Title or Position : MEMBER
Name : DR. KIMBERLY B STIGERS
Credential : M.D.
Telephone Number : 859-219-0542
Provider Enumeration Date : 07/16/2006
Last Update Date : 10/25/2010

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Practice Fax: 859-967-5617

Directions to “BLUEGRASS BREAST IMAGING PLLC ” Practice Location

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