MEDICARE: OWENSBORO HEALTH MEDICAL GROUP, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	207P00000X	Emergency Medicine Physician
2	207Q00000X	Family Medicine Physician
3	207R00000X	Internal Medicine Physician
4	207RH0003X	Hematology & Oncology Physician	KY
5	207RI0011X	Interventional Cardiology Physician	KY
6	207V00000X	Obstetrics & Gynecology Physician	KY
7	207X00000X	Orthopaedic Surgery Physician
8	208000000X	Pediatrics Physician
9	363A00000X	Physician Assistant	KY
10	363AM0700X	Medical Physician Assistant	KY
11	363AS0400X	Surgical Physician Assistant	KY
12	363L00000X	Nurse Practitioner	KY
13	363LC0200X	Critical Care Medicine Nurse Practitioner
14	363LF0000X	Family Nurse Practitioner
15	174400000X	Specialist

General Provider Information

NPI Number	:	1780841361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OWENSBORO HEALTH MEDICAL GROUP, INC.

Provider Business Mailing Address
First Line	:	1201 PLEASANT VALLEY RD
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42303-9619
Country	:	US
Telephone Number	:	270-417-4813
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 PLEASANT VALLEY RD STE 202
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42303
Country	:	US
Telephone Number	:	270-417-7500
Fax Number	:	270-417-7509

Authorized Official
Title or Position	:	SECRETARY
Name	:	RUSSELL S RANALLO
Credential	:
Telephone Number	:	270-685-7180

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	04/25/2025

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