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General NPI Number Information
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NPI Number | 1073751673
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Entity Type | Organization
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Legal Business Name | SOUTHERN OHIO NP CARE, LLC
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 07/31/2013
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Provider Practice Location Address
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Address Line | 95 MAIN ST
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City | WEST JEFFERSON
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State | OH
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Zip | 43162-1178
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Country | US
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Telephone | 614-879-7100
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Fax | 614-879-7151
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Provider Business Mailing Address
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Address Line | 40 N LAKESHORE DR
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City | SPRINGBORO
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State | OH
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Zip | 45066-8125
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Country | US
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Telephone | 937-790-0969
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Fax | 937-748-8379
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | MR. ERIC JAMES YOON
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Credential | APN
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Telephone | 937-790-0969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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