Basic Information
| Provider Information | |||||||||
| NPI: | 1891749289 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TAYLOR COUNTY RADIOLOGY, PSC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 103 WIND HAVEN DR | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | NICHOLASVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403568025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002829221 | ||||||||
| FaxNumber: | 8592232732 | ||||||||
| Practice Location | |||||||||
| Address1: | 1700 OLD LEBANON RD | ||||||||
| Address2: | TAYLOR COUNTY HOSPITAL | ||||||||
| City: | CAMPBELLSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 427189662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002829221 | ||||||||
| FaxNumber: | 8592232273 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HART | ||||||||
| AuthorizedOfficialFirstName: | CYNTHIA | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8006464741 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 29433 | KY | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.