Provider Demographics
NPI:1376877555
Name:UNIVERSITY OF KENTUCKY DEPARTMENT OF RADIOLOGY
Entity Type:Organization
Organization Name:UNIVERSITY OF KENTUCKY DEPARTMENT OF RADIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:QUANDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-323-6878
Mailing Address - Street 1:740 S LIMESTONE ST RM A125
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-323-8778
Mailing Address - Fax:
Practice Address - Street 1:740 S LIMESTONE ST RM A125
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-8778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6076P282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital