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2235 Mayfair Dr Owensboro KY 42301-4519 | |
| (270) 688-1500 | |
| (270) 688-1501 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Obesity Medicine |
| Location | 2235 Mayfair Dr, Owensboro, Kentucky |
| Authorized Official Name and Position | Russell S Ranallo (SECRETARY) |
| Authorized Official Contact | 2706857180 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 23229 Owensboro KY 42304-3229 Ph: (270) 688-1330 | 2235 Mayfair Dr Owensboro KY 42301-4519 Ph: (270) 688-1500 |
| NPI Number | 1992292288 |
|---|---|
| Provider Enumeration Date | 04/23/2018 |
| Last Update Date | 01/17/2025 |
| Certification Date | 01/17/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992292288 | NPI | - | NPPES |
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