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NPI Code Detail

MEDICARE: DR. JACQUELINE NAOMI SANDOR D.O.

MEDICARE:  DR. JACQUELINE NAOMI SANDOR  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 Physician34.008399OH

Other Identifiers

General Provider Information

NPI Number : 1649231002
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACQUELINE NAOMI SANDOR D.O.
Provider Business Mailing Address
First Line : 50 N PROGRESS DR
Second Line :
City : XENIA
State : OH
Zip : 45385-2666
Country : US
Telephone Number : 937-562-2280
Fax Number : 937-562-2282
Provider Business Practice Location Address
First Line : 50 N PROGRESS DR
Second Line :
City : XENIA
State : OH
Zip : 45385-2666
Country : US
Telephone Number : 937-562-2280
Fax Number : 937-562-2282
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 10/31/2024

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Directions to “ DR. JACQUELINE NAOMI SANDOR D.O.” Practice Location

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