Healthcare Provider Details

I. General information

NPI: 1699466433
Provider Name (Legal Business Name): OHIO VALLEY PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 05/15/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 OAK RIDGE CT
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 Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

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