| Fairborn Family Practice Assoc | |
|
850 E Xenia Drive Suite 600 Fairborn OH 45324-8760 | |
| (937) 878-8644 | |
| (937) 878-8646 |
| Full Name | Fairborn Family Practice Assoc |
|---|---|
| Speciality | Family Medicine |
| Location | 850 E Xenia Drive, Fairborn, Ohio |
| Authorized Official Name and Position | John Joseph Peterangelo (PRESIDENT) |
| Authorized Official Contact | 9378788644 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairborn Family Practice Assoc 850 E Xenia Drive Suite 600 Fairborn OH 45324-8760 Ph: (937) 878-8644 | Fairborn Family Practice Assoc 850 E Xenia Drive Suite 600 Fairborn OH 45324-8760 Ph: (937) 878-8644 |
| NPI Number | 1548224579 |
|---|---|
| Provider Enumeration Date | 04/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548224579 | NPI | - | NPPES |
| 0003193 | Other | TRICARE | |
| 0220513 | Medicaid | OH | |
| 000000005178 | Other | OH | ANTHEM BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 34002102P (Ohio) | Primary |
Fairborn Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1145 Channingway Dr, Fairborn, OH 45324 Phone: 937-878-8644 Fax: 937-878-8646 | |
Intecare, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 530 E Dayton Yellow Springs Rd, Fairborn, OH 45324 Phone: 937-874-5766 Fax: 937-874-5774 | |
Ohio Valley Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7790 Dayton Springfield Rd Ste B, Fairborn, OH 45324 Phone: 937-340-6440 Fax: 937-340-6441 | |
Dan F Bautista Md Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1840 Commerce Center Blvd, Fairborn, OH 45324 Phone: 937-754-4580 Fax: 937-754-4575 | |
Digestive Specialists Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7790 Dayton Springfield Rd Ste B, Fairborn, OH 45324 Phone: 937-293-4424 Fax: 937-395-3682 | |
Manoj R Desai, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 717 W Xenia Dr, Fairborn, OH 45324 Phone: 937-878-4531 Fax: 937-878-4070 |