Provider Demographics
NPI:1982671558
Name:ASCANI, ENRICO III (MD)
Entity Type:Individual
Prefix:
First Name:ENRICO
Middle Name:
Last Name:ASCANI
Suffix:III
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 1987
Mailing Address - Street 2:
Mailing Address - City:HYDEN
Mailing Address - State:KY
Mailing Address - Zip Code:41749-1987
Mailing Address - Country:US
Mailing Address - Phone:606-791-4446
Mailing Address - Fax:606-439-1400
Practice Address - Street 1:1019 CUMBERLAND FALLS HWY STE D141
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2796
Practice Address - Country:US
Practice Address - Phone:606-528-5527
Practice Address - Fax:606-526-9687
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33775207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64337751Medicaid
KY0776309Medicare PIN
H26920Medicare UPIN
KY183918Medicare Oscar/Certification
KY00051003Medicare PIN
KY64337751Medicaid