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NPI Code Detail

MEDICARE: MID-OHIO EMERGENCY PHYSICIANS, LLP

MEDICARE: MID-OHIO EMERGENCY PHYSICIANS, LLP
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
1207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1205227196
Entity Type Code : Organization
Provider Name (Legal Business Name) : MID-OHIO EMERGENCY PHYSICIANS, LLP
Provider Business Mailing Address
First Line : 75 REMIT DR # 1122
Second Line :
City : CHICAGO
State : IL
Zip : 60675-1122
Country : US
Telephone Number : 800-701-3381
Fax Number : 231-932-4133
Provider Business Practice Location Address
First Line : 199 W MAIN ST
Second Line :
City : SHELBY
State : OH
Zip : 44875-1490
Country : US
Telephone Number : 800-701-3381
Fax Number : 231-932-4133
Authorized Official
Title or Position : MANAGING PARTNER
Name : DERIK K KING
Credential : M.D.
Telephone Number : 337-609-1221
Provider Enumeration Date : 02/12/2015
Last Update Date : 03/23/2022

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Directions to “MID-OHIO EMERGENCY PHYSICIANS, LLP ” Practice Location

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