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NPI Code Detail

MEDICARE: MEDICAL SERVICES OF COSHOCTON, INC

MEDICARE: MEDICAL SERVICES OF COSHOCTON, 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
1207R00000XInternal Medicine Physician

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 : 1407889785
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICAL SERVICES OF COSHOCTON, INC
Provider Business Mailing Address
First Line : PO BOX 57
Second Line :
City : WEST LAFAYETTE
State : OH
Zip : 43845-0057
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 101 W DAVE LONGABERGER AVE
Second Line :
City : DRESDEN
State : OH
Zip : 43821-9687
Country : US
Telephone Number : 740-754-1041
Fax Number :
Authorized Official
Title or Position : CEO
Name : ROBERT MILLER
Credential :
Telephone Number : 740-623-4009
Provider Enumeration Date : 07/09/2006
Last Update Date : 08/22/2020

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Directions to “MEDICAL SERVICES OF COSHOCTON, INC ” Practice Location

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