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Professional Park Diagnostics, PLLC

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Company Details

Name: Professional Park Diagnostics, PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 25 Apr 2019 (6 years ago)
Organization Date: 25 Apr 2019 (6 years ago)
Last Annual Report: 24 Feb 2025 (4 months ago)
Managed By: Members
Organization Number: 1056720
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 42303
City: Owensboro
Primary County: Daviess County
Principal Office: 3346 Professional Park Drive, Owensboro, KY 42303
Place of Formation: KENTUCKY

Registered Agent

Name Role
Mark Starnes Registered Agent

Member

Name Role
Patrick B Gipe Member

National Provider Identifier

NPI Number:
1902403264
Certification Date:
2020-10-15

Authorized Person:

Name:
DEBRA T MATTINGLY
Role:
CREDENTIALING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
261QR0200X - Radiology Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2708528924

Filings

Name File Date
Annual Report 2025-02-24
Annual Report 2024-03-25
Annual Report 2023-03-21
Annual Report 2022-03-28
Annual Report 2021-03-08

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Sources: Kentucky Secretary of State