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General NPI Number Information
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NPI Number | 1538224613
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Entity Type | Organization
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Legal Business Name | SOUTH COURT FAMILY PRACTICE CENTER, INC.
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 600 N PICKAWAY ST SUITE 204
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City | CIRCLEVILLE
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State | OH
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Zip | 43113-2409
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Country | US
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Telephone | 740-420-0100
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Fax | 740-420-0103
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Provider Business Mailing Address
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Address Line | 600 N PICKAWAY ST SUITE 204
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City | CIRCLEVILLE
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State | OH
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Zip | 43113-2409
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Country | US
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Telephone | 740-420-0100
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Fax | 740-420-0103
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TAPASWINI A TRIVEDI
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Credential | M..D.
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Telephone | 740-420-0100
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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 | 35076625-T
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License Number State | OH
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