PROFESSIONAL PARK DIAGNOSTICS PLLC NPI 1902403264

NPI Information

NPI: 1902403264
Provider Name: PROFESSIONAL PARK DIAGNOSTICS PLLC

Doing Business As: PROFESSIONAL PARK DIAGNOSTICS PLLC, , RADIOLOGY

Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

Address:
3346 PROFESSIONAL PARK
SUITE A
OWENSBORO, KY
ZIP 42303
Phone: (270) 228-0405
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PROFESSIONAL PARK DIAGNOSTICS PLLC is a radiology clinic center in Owensboro, KY. PROFESSIONAL PARK DIAGNOSTICS PLLC NPI is 1902403264. The provider is registered as an organization entity type.
The provider Is Doing Business As Professional Park Diagnostics Pllc, , Radiology.

The provider's business location address is:

3346 PROFESSIONAL PARK
SUITE A
OWENSBORO, KY
ZIP 42303-551
Phone: (270) 228-0405
Fax: (270) 852-8924

The provider's authorized official is Debra T Mattingly .
The authorized official title is Credentialing Manager and has the following contact phone number (270) 852-8931.

The enumeration date for this NPI number is 10/8/2020 and was last updated on 10/15/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0200X	Clinic/Center	Radiology			Yes

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

NPI Synchronization or Removal

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