Healthcare Provider Details

I. General information

NPI: 1700830916
Provider Name (Legal Business Name): ASHLAND ANESTHESIA, P.S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SAINT CHRISTOPHER DR
ASHLAND KY
41101-7034
US

IV. Provider business mailing address

PO BOX 29
ASHLAND KY
41105-0029
US

V. Phone/Fax

Practice location:
  • Phone: 606-833-3791
  • Fax:
Mailing address:
  • Phone: 877-416-4452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL NESTOR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 606-833-3791