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General NPI Number Information
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NPI Number | 1083888010
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Entity Type | Organization
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Legal Business Name | BUCKEYE FAMILY MEDICINE INC
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 06/03/2010
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Provider Practice Location Address
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Address Line | 1570 CLEVELAND AVE
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City | COLUMBUS
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State | OH
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Zip | 43211-2755
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Country | US
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Telephone | 614-299-9532
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Fax | 614-299-9533
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Provider Business Mailing Address
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Address Line | 2575 W BROAD ST
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City | COLUMBUS
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State | OH
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Zip | 43204-3333
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Country | US
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Telephone | 614-278-9666
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Fax | 614-278-2385
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KATHY MCDANIELS
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Credential |
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Telephone | 614-278-9666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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