Healthcare Provider Details
I. General information
NPI: 1497044531
Provider Name (Legal Business Name): OHIO VALLEY NEPHROLOGY ASSOCIATES PSC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/29/2011
Last Update Date: 03/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1602 MAIN ST
TELL CITY IN
47586-1310
US
IV. Provider business mailing address
1930 E PARRISH AVE
OWENSBORO KY
42303-1443
US
V. Phone/Fax
- Phone: 812-719-4237
- Fax: 812-547-1150
- Phone: 270-689-1919
- Fax: 270-689-1990
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
THERESA
MARIE
SEATON
Title or Position: ACCOUNTS MANAGER
Credential:
Phone: 270-689-1919