Healthcare Provider Details
I. General information
NPI: 1669426755
Provider Name (Legal Business Name): OHIO VALLEY ENT & ALLERGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2006
Last Update Date: 06/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2125 STATE ST SUITE 6
NEW ALBANY IN
47150-4922
US
IV. Provider business mailing address
2125 STATE ST SUITE 6
NEW ALBANY IN
47150-4922
US
V. Phone/Fax
- Phone: 812-945-3557
- Fax: 812-949-3599
- Phone: 812-945-3557
- Fax: 812-949-3599
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207YX0602X |
| Taxonomy | Otolaryngic Allergy Physician |
| License Number | |
| License Number State | IN |
VIII. Authorized Official
Name: DR.
DANIEL
P
AKIN
Title or Position: PRESIDENT
Credential: MD
Phone: 812-945-3557