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NPI Code Detail

MEDICARE: DR. GERALDINE LEE URSE D.O.

MEDICARE: DR. GERALDINE LEE URSE D.O.
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
1207Q00000XFamily Medicine PhysicianOH005976OH

Other Identifiers

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

General Provider Information

NPI Number : 1285616722
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERALDINE LEE URSE D.O.
Provider Business Mailing Address
First Line : 2030 STRINGTOWN RD
Second Line :
City : GROVE CITY
State : OH
Zip : 43123-3993
Country : US
Telephone Number : 614-544-0101
Fax Number : 614-544-0102
Provider Business Practice Location Address
First Line : 2030 STRINGTOWN RD
Second Line :
City : GROVE CITY
State : OH
Zip : 43123-3993
Country : US
Telephone Number : 614-544-0101
Fax Number : 614-544-0102
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 12/20/2012

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