MEDICARE: DOCTORS PRIMARY CARE - HILLIARD, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194736140
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS PRIMARY CARE - HILLIARD, INC

Provider Business Mailing Address
First Line	:	5548 HILLIARD ROME OFFICE PARK
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-7286
Country	:	US
Telephone Number	:	614-850-9311
Fax Number	:	614-850-9314

Provider Business Practice Location Address
First Line	:	5548 HILLIARD ROME OFFICE PARK
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-7286
Country	:	US
Telephone Number	:	614-850-9311
Fax Number	:	614-850-9314

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	ROBERT STRAVELER
Credential	:
Telephone Number	:	614-367-1679

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	08/22/2020

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