Healthcare Provider Details

I. General information

NPI: 1093057283
Provider Name (Legal Business Name): EMILY GEORGE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 W MAIN ST STE A
LOUISVILLE OH
44641-1114
US

IV. Provider business mailing address

1302 W MAIN ST
LOUISVILLE OH
44641-1114
US

V. Phone/Fax

Practice location:
  • Phone: 330-875-5544
  • Fax:
Mailing address:
  • Phone: 330-875-5544
  • Fax: 330-875-8150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.128666
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: