| Charles P House Sr Do | |
|
700 W Maple St Clyde OH 43410-1414 | |
| (419) 547-0584 | |
| (419) 547-8918 |
| Full Name | Charles P House Sr Do |
|---|---|
| Speciality | Family Medicine |
| Location | 700 W Maple St, Clyde, Ohio |
| Authorized Official Name and Position | Charles P House (PRESIDENT) |
| Authorized Official Contact | 4195470584 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles P House Sr Do Po Box 179 Bellevue OH 44811-0179 Ph: (440) 274-5035 | Charles P House Sr Do 700 W Maple St Clyde OH 43410-1414 Ph: (419) 547-0584 |
| NPI Number | 1497724140 |
|---|---|
| Provider Enumeration Date | 03/15/2006 |
| Last Update Date | 02/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497724140 | NPI | - | NPPES |
| 603819300 | Other | OH | DEPT OF LABOR |
| DC6183 | Other | OH | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Northwest Primary Care, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 455 W Mcpherson Hwy, Clyde, OH 43410 Phone: 419-541-8555 Fax: 419-547-9119 | |
North Central Family Physicians Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 W Mcpherson Hwy, Clyde, OH 43410 Phone: 419-547-0584 Fax: 419-547-8918 |