Healthcare Provider Details

I. General information

NPI: 1033178777
Provider Name (Legal Business Name): TROY KENNETH ASHCRAFT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 01/10/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BLACKBURN LN
DRY RIDGE KY
41035-8806
US

IV. Provider business mailing address

PO BOX 635283
CINCINNATI OH
45263-5283
US

V. Phone/Fax

Practice location:
  • Phone: 859-823-5441
  • Fax: 859-823-5001
Mailing address:
  • Phone: 859-823-5441
  • Fax: 859-823-5001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02606
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: