Healthcare Provider Details

I. General information

NPI: 1831137058
Provider Name (Legal Business Name): ASHLAND EMERGENCY MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 04/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 LEXINGTON AVE EMERGENCY DEPARTMENT
ASHLAND KY
41101-2843
US

IV. Provider business mailing address

PO BOX 989
ASHLAND KY
41105-0989
US

V. Phone/Fax

Practice location:
  • Phone: 606-922-2291
  • Fax:
Mailing address:
  • Phone: 606-922-2291
  • Fax: 260-407-8007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRETT E. JARRELL
Title or Position: GROUP PRESIDENT
Credential: M.D.
Phone: 606-922-2291