Healthcare Provider Details

I. General information

NPI: 1811951478
Provider Name (Legal Business Name): BRIAN L. ASH D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 09/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7797 JOAN DR
WEST CHESTER OH
45069-3682
US

IV. Provider business mailing address

7797 JOAN DR
WEST CHESTER OH
45069-3682
US

V. Phone/Fax

Practice location:
  • Phone: 513-779-9673
  • Fax: 513-779-3452
Mailing address:
  • Phone: 513-779-9673
  • Fax: 513-779-3452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number36-00-3391
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number36-00-3391
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36-00-3391
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: