Organization
PHOENIX PSYCHIATRY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMMANUEL EZE MD (OWNER)
(606) 329-1016
Entity
Organization
Contact information
Practice address
1544 WINCHESTER AVE, SUITE 701, ASHLAND, KY 41101-7923
(606) 329-1016
Mailing address
PO BOX 650, ASHLAND, KY 41105-0650
(606) 329-1016
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
31810
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65941460
—
KY
01
—
DB8637
RAILROAD MEDICARE
—
Enumeration date
09/13/2006
Last updated
01/11/2008
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