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NPI Code Detail

MEDICARE: MID-OHIO FAMILY PRACTICE ASSOCIATES LLC

MEDICARE: MID-OHIO FAMILY PRACTICE ASSOCIATES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568989945
Entity Type Code : Organization
Provider Name (Legal Business Name) : MID-OHIO FAMILY PRACTICE ASSOCIATES LLC
Provider Business Mailing Address
First Line : 4889 AUGUSTA WOODS CT
Second Line :
City : WESTERVILLE
State : OH
Zip : 43082-9180
Country : US
Telephone Number : 614-937-4957
Fax Number :
Provider Business Practice Location Address
First Line : 2800 W BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-2654
Country : US
Telephone Number : 614-274-4171
Fax Number :
Authorized Official
Title or Position : OWNER
Name : THOMPSON NWOSU
Credential :
Telephone Number : 614-330-9798
Provider Enumeration Date : 08/25/2017
Last Update Date : 07/06/2020

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Directions to “MID-OHIO FAMILY PRACTICE ASSOCIATES LLC ” Practice Location

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