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General NPI Number Information
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NPI Number | 1801994827
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Entity Type | Organization
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Legal Business Name | HOCKING VALLEY MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 601 STATE ROUTE 664 N
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City | LOGAN
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State | OH
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Zip | 43138-8541
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Country | US
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Telephone | 740-380-8140
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Fax | 740-380-8150
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Provider Business Mailing Address
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Address Line | PO BOX 228
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City | LOGAN
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State | OH
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Zip | 43138-0228
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Country | US
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Telephone | 740-385-7564
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Fax | 740-385-7566
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | KIMBERLY BROWN
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Credential |
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Telephone | 740-380-8350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | OH
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Taxonomy #6
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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 | OH
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Taxonomy #7
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | OH
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Taxonomy #8
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State | OH
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Taxonomy #9
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | OH
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Taxonomy #10
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | OH
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