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NPI Code Detail

MEDICARE: BUCKEYE FAMILY MEDICINE INC

MEDICARE: BUCKEYE FAMILY MEDICINE 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
1207Q00000XFamily 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
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31699702571OTHEROHDME

General Provider Information

NPI Number : 1578599171
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUCKEYE FAMILY MEDICINE INC
Provider Business Mailing Address
First Line : 2575 W BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-3333
Country : US
Telephone Number : 614-278-9666
Fax Number : 614-278-2385
Provider Business Practice Location Address
First Line : 2575 W BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-3333
Country : US
Telephone Number : 614-278-9666
Fax Number : 614-278-2385
Authorized Official
Title or Position : PRESIDENT
Name : KATHY MCDANIELS
Credential :
Telephone Number : 614-278-9666
Provider Enumeration Date : 06/24/2006
Last Update Date : 06/04/2010

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Directions to “BUCKEYE FAMILY MEDICINE INC ” Practice Location

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