Provider Demographics
NPI:1104220409
Name:OHIO VALLEY PHYSICIANS, INC
Entity type:Organization
Organization Name:OHIO VALLEY PHYSICIANS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ENDLICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-429-1088
Mailing Address - Street 1:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25708-0390
Mailing Address - Country:US
Mailing Address - Phone:304-752-3435
Mailing Address - Fax:304-752-3436
Practice Address - Street 1:557 MAIN ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601-3809
Practice Address - Country:US
Practice Address - Phone:740-752-3435
Practice Address - Fax:740-753-3436
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHIO VALLEY PHYSICIANS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-15
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty