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General NPI Number Information
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NPI Number | 1194744144
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Entity Type | Organization
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Legal Business Name | MT. CARMEL FAMILY MEDICINE, INC.
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 473 OLD STATE ROUTE 74 SUITE 4
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City | CINCINNATI
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State | OH
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Zip | 45244
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Country | US
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Telephone | 513-528-1505
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Fax | 513-528-5982
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Provider Business Mailing Address
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Address Line | PO BOX 631997
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City | CINCINNATI
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State | OH
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Zip | 45263-0020
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Country | US
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Telephone | 513-528-1505
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Fax | 513-528-5982
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Authorized Official
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Title or Position | PRESIDENT
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Name | DONALD R WILLIAMS
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Credential | MD
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Telephone | 513-528-1505
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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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