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General NPI Number Information
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NPI Number | 1366379075
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Entity Type | Organization
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Legal Business Name | PHOENIX CENTER, INC.
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 1007 N 2ND ST
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City | IRONTON
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State | OH
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Zip | 45638-1235
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Country | US
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Telephone | 740-442-7045
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Fax | 740-442-7047
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Provider Business Mailing Address
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Address Line | PO BOX 614
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City | IRONTON
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State | OH
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Zip | 45638-0614
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Country | US
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Telephone | 740-442-7045
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Fax | 740-442-7047
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Authorized Official
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Title or Position | COMPLIANCE AND RISK DIRECTOR
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Name | KASEY MCCALLISTER
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Credential |
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Telephone | 740-442-7045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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