Healthcare Provider Details

I. General information

NPI: 1386779981
Provider Name (Legal Business Name): ASHLAND ENDOCRINOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 CENTER ST
ASHLAND OH
44805-4063
US

IV. Provider business mailing address

934 CENTER ST
ASHLAND OH
44805-4063
US

V. Phone/Fax

Practice location:
  • Phone: 419-281-2222
  • Fax: 419-281-0000
Mailing address:
  • Phone: 419-281-2222
  • Fax: 419-281-0000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number83371
License Number StateOH

VIII. Authorized Official

Name: ANGELA NOVY
Title or Position: EMPLOYEE AND PRESIDENT
Credential: MD
Phone: 419-281-2222