Healthcare Provider Details

I. General information

NPI: 1194423822
Provider Name (Legal Business Name): OHIO VALLEY PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2023
Last Update Date: 02/22/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2180 2ND ST
MASON WV
25260
US

IV. Provider business mailing address

PO BOX 390
HUNTINGTON WV
25708-0390
US

V. Phone/Fax

Practice location:
  • Phone: 304-773-3135
  • Fax: 304-773-3136
Mailing address:
  • Phone: 304-429-1088
  • Fax: 304-429-3109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RACHEL LYNN BLANKENSHIP
Title or Position: LEAD CREDENTIALING SPECIALIST
Credential:
Phone: 304-429-1088