Provider Demographics
NPI:1003004235
Name:ASHLAND FOOTCARE
Entity Type:Organization
Organization Name:ASHLAND FOOTCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JESS
Authorized Official - Middle Name:
Authorized Official - Last Name:SONGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-324-1994
Mailing Address - Street 1:841 29TH ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-3019
Mailing Address - Country:US
Mailing Address - Phone:606-324-1994
Mailing Address - Fax:606-324-2274
Practice Address - Street 1:841 29TH ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-3019
Practice Address - Country:US
Practice Address - Phone:606-324-1994
Practice Address - Fax:606-324-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00118213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty