| Hospital Services Medical Group Of Clark County Inc | |
|
2615 E High St Springfield OH 45505-1412 | |
| (937) 325-0531 | |
| Not Available |
| Full Name | Hospital Services Medical Group Of Clark County Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2615 E High St, Springfield, Ohio |
| Authorized Official Name and Position | Paul W Kolodzik (COO) |
| Authorized Official Contact | 8007263627 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hospital Services Medical Group Of Clark County Inc 4750 Hempstead Station Dr Kettering OH 45429-5164 Ph: (800) 875-0136 | Hospital Services Medical Group Of Clark County Inc 2615 E High St Springfield OH 45505-1412 Ph: (937) 325-0531 |
| NPI Number | 1588659841 |
|---|---|
| Provider Enumeration Date | 09/13/2005 |
| Last Update Date | 09/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588659841 | NPI | - | NPPES |
| 203409 | Other | OH | EEOICP GRP PROVIDER # |
| 202763100 | Other | OH | DOL GRP PROVIDER NUMBER |
| 2490844 | Medicaid | OH | |
| 020406300 | Other | OH | FBLP GRP PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 1429529 (Ohio) | Primary |
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