Provider Demographics
NPI:1295137420
Name:OHIO VALLEY SURGEONS, INC.
Entity type:Organization
Organization Name:OHIO VALLEY SURGEONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SHACKELFORD
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:740-695-2443
Mailing Address - Street 1:46150 NATIONAL RD W
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8715
Mailing Address - Country:US
Mailing Address - Phone:740-695-2443
Mailing Address - Fax:740-695-2511
Practice Address - Street 1:46150 NATIONAL RD W
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8715
Practice Address - Country:US
Practice Address - Phone:740-695-2443
Practice Address - Fax:740-695-2511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH07-102246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty