| Kaiser Medical Corporation | |
|
562 N Main St Springboro OH 45066-9552 | |
| (937) 748-8026 | |
| (937) 748-8030 |
| Full Name | Kaiser Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 562 N Main St, Springboro, Ohio |
| Authorized Official Name and Position | George M Kaiser (OWNER) |
| Authorized Official Contact | 9377488026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaiser Medical Corporation 562 N Main St Springboro OH 45066-9552 Ph: (937) 748-8026 | Kaiser Medical Corporation 562 N Main St Springboro OH 45066-9552 Ph: (937) 748-8026 |
| NPI Number | 1407935828 |
|---|---|
| Provider Enumeration Date | 11/05/2006 |
| Last Update Date | 12/03/2007 |
| Medicare PECOS PAC ID | 2668384306 |
|---|---|
| Medicare Enrollment ID | O20031103000163 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407935828 | NPI | - | NPPES |
| 2427636 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | George M Kaiser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891808002 PECOS PAC ID: 0547172199 Enrollment ID: I20031106000182 |
| Provider Name | Krisell D Fedrizzi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497757736 PECOS PAC ID: 4880622794 Enrollment ID: I20050802000226 |
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