Healthcare Provider Details

I. General information

NPI: 1235828245
Provider Name (Legal Business Name): BUCKEYE MOBILE DOT EXAMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 FLOYD ST
LEWISBURG OH
45338-9572
US

IV. Provider business mailing address

PO BOX 532
LEWISBURG OH
45338-0532
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-9389
  • Fax:
Mailing address:
  • Phone: 937-641-9389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. WEST N FOSTER
Title or Position: FNP
Credential: FNP
Phone: 937-641-9389