S Douglas Deitch MD PSC

Primary specialty

SpecialistTaxonomy code 174400000X

License

26535 Issued in KY

Legal business name

S DOUGLAS DEITCH MD PSC

Practice address

2301 Lexington Ave
Suite 310
Ashland, KY 41101-2873

Phone

(606) 325-3299

Fax

(606) 325-1386

NPI assigned

Sep 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Stephen Douglas Deitch, MD

Title

Owner

Phone

(606) 325-3299

Specialties & licenses 1

Addresses

Other identifiers 9

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Douglas Deitch, M.D.

  • Neurology Physician
  • Ashland, KY
  • NPI 1912003781

  Specialist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1770779084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 LEXINGTON AVE",
            "address_2": "SUITE 310",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012873",
            "telephone_number": "606-325-3299",
            "fax_number": "606-325-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 LEXINGTON AVE",
            "address_2": "SUITE 310",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012873",
            "telephone_number": "606-325-3299",
            "fax_number": "606-325-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S DOUGLAS DEITCH MD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "DEITCH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-325-3299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "KY",
            "license": "26535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4347345",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64265358",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1389552",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0042484000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "1498201",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID GROUP",
            "identifier": "4982",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000000049311",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEST VIRGINIA WORKERS COM",
            "identifier": "1030745",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0742594",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary Runyon, DO
• Brandon Russell
• James Lee Ryan
• Madison Dawn Ryan, MEDICAL COSMETICS
• Sean Patrick Ryan, MD
• S&N Medical Solutions, LLC
• Elizabeth Sagraves
• Charbel Antoine Salem, M.D.
• Galena Salem, M.D.
• Muhammad Musa Salick, M.D.

• Specialist in Ashland, KY
• Providers in Ashland, KY by specialty
• Specialist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.