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NPI Code Detail

MEDICARE: OSTEOPATHIC CENTER FOR FAMILY MEDICINE, LLC

MEDICARE: OSTEOPATHIC CENTER FOR FAMILY MEDICINE, LLC
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 PhysicianME1760ME

General Provider Information

NPI Number : 1699975078
Entity Type Code : Organization
Provider Name (Legal Business Name) : OSTEOPATHIC CENTER FOR FAMILY MEDICINE, LLC
Provider Business Mailing Address
First Line : 603 MAIN RD N
Second Line :
City : HAMPDEN
State : ME
Zip : 04444-1804
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 603 MAIN RD N
Second Line :
City : HAMPDEN
State : ME
Zip : 04444-1804
Country : US
Telephone Number : 207-945-5400
Fax Number : 866-463-6751
Authorized Official
Title or Position : MEMBER
Name : LEIGH FORBUSH
Credential : DO
Telephone Number : 207-945-5400
Provider Enumeration Date : 07/23/2007
Last Update Date : 03/25/2008

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Directions to “OSTEOPATHIC CENTER FOR FAMILY MEDICINE, LLC ” Practice Location

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