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General NPI Number Information
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NPI Number | 1174582530
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Entity Type | Organization
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Legal Business Name | LONDON FAMILY MEDICINE, INC.
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 11/25/2009
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Provider Practice Location Address
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Address Line | 55 PARK AVE SUITE 230
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City | LONDON
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State | OH
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Zip | 43140-1121
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Country | US
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Telephone | 740-845-7600
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Fax | 740-845-7676
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Provider Business Mailing Address
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Address Line | 1550 S 70TH ST STE 202 PO BOX 67250
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City | LINCOLN
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State | NE
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Zip | 68506-1576
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Country | US
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Telephone | 402-328-8833
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Fax | 402-328-2921
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN G RICHARDSON
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Credential | MD
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Telephone | 740-845-7600
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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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