Molecular Imaging of Eastern Kentucky, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

720243 Issued in 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

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert Brooks Davis, M.D.

Title

Medical Director

Phone

(330) 491-1490

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "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": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "720243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Services of Kentucky, PSC
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• Kelli Jo Montgomery, D.O.
• Jennifer Moore, APRN
• Mountain Apothecary
• Mountain Comprehensive Care Center, Inc. (Homeplace Clinic Paintsville)
• Mountain Comprehensive Care Center, Inc. (Homeplace Eye Care)

• Specialist in Paintsville, KY
• Providers in Paintsville, KY by specialty
• Specialist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.