Karl G. Rose M.d., Inc. | |
3017 Wilmington Pike Kettering OH 45429-4075 | |
(937) 294-2555 | |
(937) 294-3211 |
Full Name | Karl G. Rose M.d., Inc. |
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Speciality | Family Medicine |
Location | 3017 Wilmington Pike, Kettering, Ohio |
Authorized Official Name and Position | Karl Rose (OWNER) |
Authorized Official Contact | 9372942555 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Karl G. Rose M.d., Inc. Po Box 292305 Kettering OH 45429-0305 Ph: (937) 294-2555 | Karl G. Rose M.d., Inc. 3017 Wilmington Pike Kettering OH 45429-4075 Ph: (937) 294-2555 |
NPI Number | 1760040315 |
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Provider Enumeration Date | 05/30/2019 |
Last Update Date | 08/01/2019 |
Medicare PECOS PAC ID | 4082940820 |
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Medicare Enrollment ID | O20190731002260 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760040315 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Karl G Rose |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1235136029 PECOS PAC ID: 8123294709 Enrollment ID: I20120103000482 |
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