Healthcare Provider Details

I. General information

NPI: 1104787811
Provider Name (Legal Business Name): OHIO VALLEY ADVANCED MEDICAL SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2025
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 CAITLIN DR
UNION KY
41091-8010
US

IV. Provider business mailing address

909 CAITLIN DR
UNION KY
41091-8010
US

V. Phone/Fax

Practice location:
  • Phone: 646-406-9661
  • Fax: 903-205-9515
Mailing address:
  • Phone: 646-406-9661
  • Fax: 903-205-9515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JACQUES ALEXIS
Title or Position: CEO
Credential: MD
Phone: 646-406-9661