Healthcare Provider Details

I. General information

NPI: 1881691343
Provider Name (Legal Business Name): THOMAS ROBERT LOVE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 12/22/2020
Certification Date: 12/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 ASHLAND DR STE 103
ASHLAND KY
41101-7092
US

IV. Provider business mailing address

1735 27TH ST STE B06
PORTSMOUTH OH
45662-2681
US

V. Phone/Fax

Practice location:
  • Phone: 606-324-0098
  • Fax: 606-324-0315
Mailing address:
  • Phone: 740-356-7942
  • Fax: 740-356-7851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25675
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: