=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154652527
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SCIOTO VALLEY FAMILY PHYSICIANS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2010
-----------------------------------------------------
Last Update Date | 06/23/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14 HEALTH DR
-----------------------------------------------------
City | CHILLICOTHEE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45601-8604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-775-6162
-----------------------------------------------------
Fax | 740-775-6379
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14 HEALTH DR
-----------------------------------------------------
City | CHILLICOTHEE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45601-8604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-775-6162
-----------------------------------------------------
Fax | 740-775-6379
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. DANIEL ROBERT COLOPY
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 740-775-6162
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------