Healthcare Provider Details

I. General information

NPI: 1053266577
Provider Name (Legal Business Name): UNIFY MEDICAL PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/02/2026
Certification Date: 03/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8664 COPPERVIEW DR
DUBLIN OH
43016-8439
US

IV. Provider business mailing address

8664 COPPERVIEW DR
DUBLIN OH
43016-8439
US

V. Phone/Fax

Practice location:
  • Phone: 380-206-4137
  • Fax:
Mailing address:
  • Phone: 380-206-4137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LOIC KIZA
Title or Position: CEO
Credential: NP
Phone: 937-789-0577