Organization · Type 2 NPI

Professional Park Diagnostics PLLC

Radiology Clinic/Center · Owensboro, KY

NPI number 1902403264 Active

Practice location

3346 Professional Park, Suite A
Owensboro, KY 42303-4551

Fax (270) 852-8924

Specialties and licenses

Taxonomy	Code	License
Radiology Clinic/Center Primary	261QR0200X	None listed

Radiology Clinic/Center: Definition to come...

7 other providers at this address

Professional Park Diagnostics PLLCClinical Medical Laboratory Owensboro, KY NPI 1235795352
Annie J. Wilson, APRNFamily Nurse Practitioner Owensboro, KY NPI 1295022705
Brandy Pelphrey, APRNFamily Nurse Practitioner Owensboro, KY NPI 1104300946
Jonathan Blandford, DOInternal Medicine Physician Owensboro, KY NPI 1568811842
Leslie C. Phelps, APRNFamily Nurse Practitioner Owensboro, KY NPI 1801899588
Ramez A. Salamah, MDInternal Medicine Physician Owensboro, KY NPI 1912070038
Victoria Edwards, MDFamily Medicine Physician Owensboro, KY NPI 1568813418

NPI record

NPI: 1902403264
Entity type: Organization (Type 2)
Issued: Oct 8, 2020
Last updated: Oct 15, 2020
Status: Active

Other names

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Professional Park Diagnostics Pllc, , Radiology · doing business as
Professional Park Diagnostics Pllc, , Radiology · doing business as

Authorized official

Debra T Mattingly
Credentialing Manager
(270) 852-8931

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1902403264

Professional Park Diagnostics PLLC's National Provider Identifier is 1902403264, issued on Oct 8, 2020. The primary taxonomy on file is Radiology Clinic/Center (261QR0200X), and the practice location is in Owensboro, KY. The record was last updated on Oct 15, 2020.