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OWENSBORO HEALTH MEDICAL GROUP INC NPI 1194161984


NPI Information

NPI: 1194161984
Provider Name: OWENSBORO HEALTH MEDICAL GROUP, INC

Doing Business As: OWENSBORO HEALTH MEDICAL GROUP - FAMILY MEDICINE

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 18D1070630

Address:
1213 N MAIN ST
BEAVER DAM, KY
ZIP 42320
Phone: (270) 274-4771
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OWENSBORO HEALTH MEDICAL GROUP, INC is a rural health clinic center in Beaver Dam, KY. OWENSBORO HEALTH MEDICAL GROUP, INC NPI is 1194161984. The provider is registered as an organization entity type.
The provider Is Doing Business As Owensboro Health Medical Group - Family Medicine.

The provider's business location address is:

1213 N MAIN ST
BEAVER DAM, KY
ZIP 42320-955
Phone: (270) 274-4771
Fax: (270) 274-4884

The provider's authorized official is Russell S Ranallo .
The authorized official title is Secretary and has the following contact phone number (270) 417-4813.

The CLIA number assigned to this NPI record is 18D1070630 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/20/2013 and was last updated on 12/7/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR1300XClinic/CenterRural Health900257KENTUCKYYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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