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345 S Elizabeth St Lima OH 45801-4805 | |
| (419) 226-5075 | |
| (419) 998-4586 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 345 S Elizabeth St, Lima, Ohio |
| Authorized Official Name and Position | Jeffrey Utz (DIRECTORY OF LMP) |
| Authorized Official Contact | 4199984668 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1001 Bellefontaine Ave Lima OH 45804-2800 Ph: (419) 998-4575 | 345 S Elizabeth St Lima OH 45801-4805 Ph: (419) 226-5075 |
| NPI Number | 1023477429 |
|---|---|
| Provider Enumeration Date | 02/15/2016 |
| Last Update Date | 09/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023477429 | NPI | - | NPPES |
| 2223703 | Medicaid | OH | |
| 1457474900 | Other | OH | GROUP NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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