Provider Demographics
NPI:1174773667
Name:DX2GO
Entity type:Organization
Organization Name:DX2GO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:COYLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:BS, RPSGT
Authorized Official - Phone:502-349-6900
Mailing Address - Street 1:301 WEST STEPHEN FOSTER AVE.
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-1493
Mailing Address - Country:US
Mailing Address - Phone:502-349-6900
Mailing Address - Fax:502-349-6901
Practice Address - Street 1:301 W STEPHEN FOSTER AVE
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-1493
Practice Address - Country:US
Practice Address - Phone:502-724-7883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic