Healthcare Provider Details

I. General information

NPI: 1669684940
Provider Name (Legal Business Name): WEST CHESTER FAMILY PHYSICIANS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 09/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8859 BROOKSIDE CT SUITE 101
WEST CHESTER OH
45069-7113
US

IV. Provider business mailing address

8859 BROOKSIDE CT SUITE 101
WEST CHESTER OH
45069-7113
US

V. Phone/Fax

Practice location:
  • Phone: 513-779-6225
  • Fax: 513-779-6905
Mailing address:
  • Phone: 513-779-6225
  • Fax: 513-779-6905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VH0002X
TaxonomyHospice and Palliative Medicine (Obstetrics & Gynecology) Physician
License Number207Q00000X
License Number StateOH

VIII. Authorized Official

Name: MRS. SUSAN M CORNWELL
Title or Position: OFFICE MANGER
Credential: CMA
Phone: 513-779-6225