# JERALD M. FORD, M.D., PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326342304
- **Authorized official:** JERALD M FORD M.D. (PRESIDENT)
- **Authorized official phone:** (606) 325-1200

## Contact information

- **Practice address:** 617 23RD ST, SUITE 415, ASHLAND, KY 41101-2880
- **Practice address phone:** (606) 325-1200
- **Practice address fax:** (606) 324-9348
- **Mailing address:** PO BOX 2527, ASHLAND, KY 41105-2527
- **Mailing address phone:** (606) 325-1200
- **Mailing address fax:** (606) 324-9348

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 15865 | KY | Yes |

## Other

- **Enumeration date:** 01/05/2011
- **Last updated:** 01/05/2011