| |
1272 W Main St Bldg. 1 Newark OH 43055-2004 | |
(740) 348-1702 | |
(740) 348-1703 |
Full Name | |
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Speciality | Family Medicine |
Location | 1272 W Main St, Newark, Ohio |
Authorized Official Name and Position | Robert A. Montagnese (EXECUTIVE VICE PRESIDENT) |
Authorized Official Contact | 7403484000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1272 W Main St Bldg. 1 Newark OH 43055-2004 Ph: (740) 348-1702 | 1272 W Main St Bldg. 1 Newark OH 43055-2004 Ph: (740) 348-1702 |
NPI Number | 1336169770 |
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Provider Enumeration Date | 07/20/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336169770 | NPI | - | NPPES |
2140169 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Primetown Ohio Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 905 N 21st St Ste A, Newark, OH 43055 Phone: 740-281-3663 Fax: 740-281-3818 | |
Lower Lights Christian Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 69 S Terrace Ave, Newark, OH 43055 Phone: 614-274-1455 Fax: 614-274-1433 | |