Provider Demographics
NPI:1831137058
Name:ASHLAND EMERGENCY MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:ASHLAND EMERGENCY MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:E
Authorized Official - Last Name:JARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-922-2291
Mailing Address - Street 1:PO BOX 989
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-0989
Mailing Address - Country:US
Mailing Address - Phone:606-922-2291
Mailing Address - Fax:260-407-8007
Practice Address - Street 1:2201 LEXINGTON AVE
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2843
Practice Address - Country:US
Practice Address - Phone:606-922-2291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65911430Medicaid
INCB3924OtherRAILROAD
KY0943Medicare PIN