Healthcare Provider Details

I. General information

NPI: 1114254059
Provider Name (Legal Business Name): ABERDEEN MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2009
Last Update Date: 11/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 U.S. HIGHWAY 52
ABERDEEN OH
45101-9324
US

IV. Provider business mailing address

1650 U.S. HIGHWAY 52
ABERDEEN OH
45101-9324
US

V. Phone/Fax

Practice location:
  • Phone: 937-795-2680
  • Fax:
Mailing address:
  • Phone: 937-795-2680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVE LAJOYE
Title or Position: ADMINISTRATOR
Credential:
Phone: 513-675-2344