Provider Demographics
NPI:1366527467
Name:ASHLAND FAMILY MEDICINE
Entity type:Organization
Organization Name:ASHLAND FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SALTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-325-8261
Mailing Address - Street 1:2222 WINCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7847
Mailing Address - Country:US
Mailing Address - Phone:606-325-9644
Mailing Address - Fax:606-329-1207
Practice Address - Street 1:2222 WINCHESTER AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7847
Practice Address - Country:US
Practice Address - Phone:606-325-9644
Practice Address - Fax:606-329-1207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1208Medicare UPIN