Provider Demographics
NPI:1598756363
Name:INOSHITA, TSUYOSHI (MD)
Entity Type:Individual
Prefix:
First Name:TSUYOSHI
Middle Name:
Last Name:INOSHITA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2379
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2379
Mailing Address - Country:US
Mailing Address - Phone:606-408-6200
Mailing Address - Fax:606-408-6612
Practice Address - Street 1:916 11TH ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3411
Practice Address - Country:US
Practice Address - Phone:740-353-4884
Practice Address - Fax:740-353-8798
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45856207RH0003X
OH35.055111207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0824139Medicaid
KY000000809911OtherANTHEM BCBS
OHP01222379OtherRR MEDICARE
OH000000255209OtherANTHEM PROVIDER NUMBER
KY64869241Medicaid
OHFO3052Medicare UPIN
OH0824139Medicaid
OHP01222379OtherRR MEDICARE
OHH207270Medicare PIN