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General NPI Number Information
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NPI Number | 1265626188
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Entity Type | Organization
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Legal Business Name | FAMILY MEDICINE ASSOCIATES OF SANDUSKY CO LLC
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 1479 N RIVER RD
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City | FREMONT
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State | OH
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Zip | 43420-9760
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Country | US
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Telephone | 419-355-9440
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Fax | 419-355-9443
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Provider Business Mailing Address
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Address Line | 1479 N RIVER RD
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City | FREMONT
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State | OH
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Zip | 43420-9760
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Country | US
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Telephone | 419-355-9440
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Fax | 419-355-9443
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENNIFER GREENSLADE HOHMAN
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Credential | MD
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Telephone | 419-355-9440
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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 | 35077157
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License Number State | OH
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