Provider Demographics
NPI:1568621878
Name:OHIO VALLEY ENDOCRINOLOGY INC
Entity Type:Organization
Organization Name:OHIO VALLEY ENDOCRINOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YANCEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-375-3121
Mailing Address - Street 1:991 MEDICAL PARK DR
Mailing Address - Street 2:STE 207
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-8764
Mailing Address - Country:US
Mailing Address - Phone:606-759-0556
Mailing Address - Fax:606-759-0662
Practice Address - Street 1:991 MEDICAL PARK DR
Practice Address - Street 2:STE 207
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-8764
Practice Address - Country:US
Practice Address - Phone:606-759-0556
Practice Address - Fax:606-759-0662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000567584OtherANTHEM BCBS
OH324178OtherAMERIGROUP
OH2879621Medicaid
94124OtherAETNA
KY64051261Medicaid
KY7100050890Medicaid
000000567584OtherANTHEM BCBS
H63116Medicare UPIN