| Family Medical Practice Inc | |
|
3913 Roosevelt Blvd Middletown OH 45044-6674 | |
| (513) 423-0141 | |
| (513) 423-2677 |
| Full Name | Family Medical Practice Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 3913 Roosevelt Blvd, Middletown, Ohio |
| Authorized Official Name and Position | Omer C Hurlburt (OWNER) |
| Authorized Official Contact | 5134230141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Practice Inc 3913 Roosevelt Blvd Middletown OH 45044-6674 Ph: (513) 423-0141 | Family Medical Practice Inc 3913 Roosevelt Blvd Middletown OH 45044-6674 Ph: (513) 423-0141 |
| NPI Number | 1013993310 |
|---|---|
| Provider Enumeration Date | 12/19/2005 |
| Last Update Date | 07/30/2015 |
| Medicare PECOS PAC ID | 3072546779 |
|---|---|
| Medicare Enrollment ID | O20091216000058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013993310 | NPI | - | NPPES |
| 2378305 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Ohio) | Primary |
| Provider Name | Omer C Hurlburt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578549861 PECOS PAC ID: 6709819402 Enrollment ID: I20091216000024 |
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