Healthcare Provider Details

I. General information

NPI: 1750374039
Provider Name (Legal Business Name): ROBERT E ALBRIGHT JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 MEDICAL CENTER DR
SEAMAN OH
45679-8002
US

IV. Provider business mailing address

PO BOX 18
WINCHESTER OH
45697-0018
US

V. Phone/Fax

Practice location:
  • Phone: 937-386-3432
  • Fax: 937-386-3569
Mailing address:
  • Phone: 513-314-2845
  • Fax: 513-586-0123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number35060067
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number35060067
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: