Provider Demographics
NPI:1932063393
Name:ASHLAND INTERNAL MEDICINE, PLLC
Entity type:Organization
Organization Name:ASHLAND INTERNAL MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-240-1987
Mailing Address - Street 1:201 N WASHINGTON HWY STE 306
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-1644
Mailing Address - Country:US
Mailing Address - Phone:804-798-1092
Mailing Address - Fax:804-798-1475
Practice Address - Street 1:201 N WASHINGTON HWY STE 306
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-1644
Practice Address - Country:US
Practice Address - Phone:804-798-1092
Practice Address - Fax:804-798-1475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-10
Last Update Date:2025-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty