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General NPI Number Information
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NPI Number | 1982099438
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Entity Type | Organization
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Legal Business Name | ASHLAND INTEGRATIVE MEDICINE LLC
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Dates
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Enumeration Date | 04/01/2015
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Last Update Date | 06/24/2015
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Provider Practice Location Address
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Address Line | 10730 MIDLAND TRAIL RD
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City | ASHLAND
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State | KY
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Zip | 41102
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Country | US
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Telephone | 606-393-6193
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Fax | 606-618-9280
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Provider Business Mailing Address
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Address Line | 10730 MIDLAND TRAIL RD
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City | ASHLAND
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State | KY
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Zip | 41102
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Country | US
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Telephone | 606-393-6193
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Fax | 606-618-9280
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MRS. JEANNINE L PARIKH
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Credential | MD
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Telephone | 606-393-6193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QB0002X
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Taxonomy Name | Obesity Medicine (Family Medicine) Physician
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License Number | 39307
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 39307
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License Number State | KY
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