Individual
EMMANUEL E EZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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
01
—
000000324519
BLUE CROSS & BLUE SHIELD
KY
05
—
0115962001
—
WV
05
—
2115240
—
OH
05
—
64318108
—
KY
01
—
P00133162
RAILROAD MEDICARE
KY
Enumeration date
09/13/2006
Last updated
10/25/2007
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