Molecular Imaging of Eastern Kentucky, LLC

Key facts

NPI: 1194720185
Entity type: Organization (NPI type 2)
Primary specialty: Specialist 174400000X
License: 720243 (KY)
Legal business name: MOLECULAR IMAGING OF EASTERN KENTUCKY, LLC
Practice address: 625 James S. Trimble Blvd
Paintsville, KY 41240
Phone: (606) 920-9988
Fax: (606) 920-9978
NPI assigned: Jun 16, 2005
Organization subpart: No

Authorized official

Name: Dr. Robert Brooks Davis, M.D.
Title: Medical Director
Phone: (330) 491-1490

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Specialist Group: 193400000X SINGLE SPECIALTY GROUP	174400000X	720243	KY	Yes

Addresses

Primary practice location

625 James S. Trimble Blvd
Paintsville, KY 41240

Mailing address

4197 Fulton Dr NW
Ste C
Canton, OH 44718-2819
Phone (330) 491-1490

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194720185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4197 FULTON DR NW",
            "address_2": "STE C",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182819",
            "telephone_number": "330-491-1490",
            "fax_number": "330-491-1466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 JAMES S. TRIMBLE BLVD",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "41240",
            "telephone_number": "606-920-9988",
            "fax_number": "606-920-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLECULAR IMAGING OF EASTERN KENTUCKY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BROOKS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "330-491-1490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "KY",
            "license": "720243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paintsville, KY

All providers in Paintsville, KY · Specialist in Kentucky

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.