Provider Demographics
NPI:1275649980
Name:KENNETH H ASH MD PC
Entity Type:Organization
Organization Name:KENNETH H ASH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:H
Authorized Official - Last Name:ASH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-495-4685
Mailing Address - Street 1:128 6TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-5160
Mailing Address - Country:US
Mailing Address - Phone:970-495-4685
Mailing Address - Fax:
Practice Address - Street 1:128 6TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-5160
Practice Address - Country:US
Practice Address - Phone:970-495-4685
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO154312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COD3616OtherBLUE CROSS BLUE SHIELD
CO016848OtherVALUE OPTIONS
COD3616OtherBLUE CROSS BLUE SHIELD
COD22853Medicare UPIN