Provider Demographics
NPI:1588224745
Name:ASHLAND PRIMARY CARE INC
Entity type:Organization
Organization Name:ASHLAND PRIMARY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-651-6880
Mailing Address - Street 1:1590 CRESTVIEW DR STE B
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-3560
Mailing Address - Country:US
Mailing Address - Phone:419-651-6880
Mailing Address - Fax:419-496-0306
Practice Address - Street 1:1590 CRESTVIEW DR STE B
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3560
Practice Address - Country:US
Practice Address - Phone:419-651-6880
Practice Address - Fax:419-496-0306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty