Healthcare Provider Details

I. General information

NPI: 1255410551
Provider Name (Legal Business Name): ORTHOPAEDIC ASSOCIATES OF BELLEFONTAINE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 TIMBER TRL
BELLEFONTAINE OH
43311-9036
US

IV. Provider business mailing address

2221 TIMBER TRL
BELLEFONTAINE OH
43311-9036
US

V. Phone/Fax

Practice location:
  • Phone: 937-599-1280
  • Fax: 937-599-1730
Mailing address:
  • Phone: 937-599-1280
  • Fax: 937-599-1730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: TAMARA INSKEEP
Title or Position: OFFICE MANAGER
Credential:
Phone: 937-599-1280