Provider Demographics
NPI:1518143825
Name:ASHLAND ORTHOPEDIC ASSOCIATES, P.S.C.
Entity type:Organization
Organization Name:ASHLAND ORTHOPEDIC ASSOCIATES, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:CZULEWICZ
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-833-5505
Mailing Address - Street 1:700 SAINT CHRISTOPHER DR
Mailing Address - Street 2:MEDICAL OFFICE BLDG. 3 SUITE 200
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7062
Mailing Address - Country:US
Mailing Address - Phone:606-833-5505
Mailing Address - Fax:606-833-5515
Practice Address - Street 1:700 SAINT CHRISTOPHER DR
Practice Address - Street 2:MEDICAL OFFICE BLDG. 3 SUITE 200
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7062
Practice Address - Country:US
Practice Address - Phone:606-833-5505
Practice Address - Fax:606-833-5515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02720207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7033Medicare PIN