Provider Demographics
NPI:1619165396
Name:KENTUCKIANA MOTION X-RAY, INC.
Entity Type:Organization
Organization Name:KENTUCKIANA MOTION X-RAY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:812-945-5515
Mailing Address - Street 1:PO BOX 6743
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47151-6743
Mailing Address - Country:US
Mailing Address - Phone:812-945-5515
Mailing Address - Fax:812-945-5632
Practice Address - Street 1:2403 GUTFORD RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-9051
Practice Address - Country:US
Practice Address - Phone:812-945-5515
Practice Address - Fax:812-945-5632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile