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General NPI Number Information
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NPI Number | 1790955789
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN OHIO AMBULATORY PHYSICIANS LLC
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 809 FARSON AVE UNIT 101
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City | BELPRE
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State | OH
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Zip | 45714-1067
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Country | US
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Telephone | 740-423-9862
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Fax | 740-423-9864
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Provider Business Mailing Address
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Address Line | 809 FARSON AVE UNIT 101
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City | BELPRE
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State | OH
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Zip | 45714-1067
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Country | US
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Telephone | 740-423-9862
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Fax | 740-423-9864
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KURT J PALAZZO
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Credential |
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Telephone | 740-423-9862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 35067200
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License Number State | OH
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