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SOMERSET OUTPATIENT DIAGNOSTIC CENTER NPI 1205858099


NPI Information

NPI: 1205858099
Provider Name: SOMERSET OUTPATIENT DIAGNOSTIC CENTER
Classification: Radiologic Technologist - 2471M2300X
Entity Type: Organization

Specialization: Mammography

Address:
600 BOGLE ST
SUITE 3
SOMERSET, KY
ZIP 42503
Phone: (606) 678-4114
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SOMERSET OUTPATIENT DIAGNOSTIC CENTER is a mammography radiologic technologist in Somerset, KY. The provider is a radiologic technologist who specializes in mammography and is appropriately educated and trained, consistent with nationally recognized standards, state statute, and facility policy in performance of mammogram imaging, exam techniques, equipment protocols, radiation safety, and patient care. SOMERSET OUTPATIENT DIAGNOSTIC CENTER NPI is 1205858099. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

600 BOGLE ST
SUITE 3
SOMERSET, KY
ZIP 42503-885
Phone: (606) 678-4114
Fax: (606) 679-5862

The provider's authorized official is Lisa Ann Mitchell .
The authorized official title is Office Manager and has the following contact phone number (606) 678-4114.

The enumeration date for this NPI number is 7/24/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12471M2300XRadiologic TechnologistMammographyFDA #169292KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
164785512MEDICAIDKENTUCKY

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: 4/28/2024

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