MEDICARE: FAMILY CARE OF ASHLAND 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	05-055568	OH

General Provider Information

NPI Number	:	1609973817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CARE OF ASHLAND INC.

Provider Business Mailing Address
First Line	:	270 PORTLAND WAY S
Second Line	:
City	:	GALION
State	:	OH
Zip	:	44833-2362
Country	:	US
Telephone Number	:	419-207-8229
Fax Number	:

Provider Business Practice Location Address
First Line	:	309 ARTHUR ST
Second Line	:
City	:	ASHLAND
State	:	OH
Zip	:	44805-3206
Country	:	US
Telephone Number	:	419-207-8229
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOHN THOMAS HANNA
Credential	:	MD
Telephone Number	:	419-407-8226

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

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