Healthcare Provider Details

I. General information

NPI: 1417333295
Provider Name (Legal Business Name): IDOX3 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 07/23/2020
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 S 3RD ST
IRONTON OH
45638-1730
US

IV. Provider business mailing address

2841 LEXINGTON AVE
ASHLAND KY
41101-3009
US

V. Phone/Fax

Practice location:
  • Phone: 606-324-2451
  • Fax: 606-324-7123
Mailing address:
  • Phone: 606-324-2451
  • Fax: 606-324-7123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER L STROHMEYER
Title or Position: SUPERVISOR
Credential:
Phone: 606-324-2451