Organization
PHOENIX HEALTH ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAMESH L GHANTA M.D. (OWNER)
(859) 737-0904
Entity
Organization
Contact information
Practice address
1021 MAJESTIC DRIVE, SUITE 100, LEXINGTON, KY 40513-1492
(859) 737-0904
(859) 737-0902
Mailing address
P.O. BOX 896, WINCHESTER, KY 40392-0896
(859) 737-0904
(859) 737-0902
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
KY32188
KY
251S00000X
Community/Behavioral Health Agency
Primary
KY35740
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65941874
—
KY
Enumeration date
06/16/2008
Last updated
06/15/2011
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