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General NPI Number Information
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NPI Number | 1407889785
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Entity Type | Organization
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Legal Business Name | MEDICAL SERVICES OF COSHOCTON, INC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 101 W DAVE LONGABERGER AVE
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City | DRESDEN
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State | OH
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Zip | 43821-9687
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Country | US
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Telephone | 740-754-1041
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 57
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City | WEST LAFAYETTE
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State | OH
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Zip | 43845-0057
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROBERT MILLER
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Credential |
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Telephone | 740-623-4009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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