Healthcare Provider Details

I. General information

NPI: 1326443102
Provider Name (Legal Business Name): OHIO VALLEY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2014
Last Update Date: 12/27/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 OAK RIDGE CT STE 3
PRESTONSBURG KY
41653-8607
US

IV. Provider business mailing address

PO BOX 390
HUNTINGTON WV
25708-0390
US

V. Phone/Fax

Practice location:
  • Phone: 606-889-1602
  • Fax: 606-263-4467
Mailing address:
  • Phone: 304-429-1088
  • Fax: 304-429-3109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MELISSA ASHWORTH
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 304-429-1088