Healthcare Provider Details

I. General information

NPI: 1982099438
Provider Name (Legal Business Name): ASHLAND INTEGRATIVE MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2015
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10730 MIDLAND TRAIL RD
ASHLAND KY
41102
US

IV. Provider business mailing address

10730 MIDLAND TRAIL RD
ASHLAND KY
41102-9679
US

V. Phone/Fax

Practice location:
  • Phone: 606-393-6193
  • Fax: 606-618-9280
Mailing address:
  • Phone: 606-922-1240
  • Fax: 606-618-9280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number39307
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number39307
License Number StateKY

VIII. Authorized Official

Name: DR. MANISH PARIKH
Title or Position: PHYSICIAN
Credential:
Phone: 606-922-1240