| Lodi Medical Group Inc. | |
|
402 Highland Dr Lodi OH 44254-1216 | |
| (330) 948-1555 | |
| (330) 948-2676 |
| Full Name | Lodi Medical Group Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 402 Highland Dr, Lodi, Ohio |
| Authorized Official Name and Position | Graciano B Dichoso (OWNER) |
| Authorized Official Contact | 3309481555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lodi Medical Group Inc. 402 Highland Dr Lodi OH 44254-1216 Ph: (330) 948-1555 | Lodi Medical Group Inc. 402 Highland Dr Lodi OH 44254-1216 Ph: (330) 948-1555 |
| NPI Number | 1932329414 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932329414 | NPI | - | NPPES |
| 0185508 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35033396 (Ohio) | Primary |
Lodi Community Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 225 Elyria St, Lodi, OH 44254 Phone: 330-948-5533 Fax: 330-948-2726 | |
Lodi Community Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 221 Elyria St, Lodi, OH 44254 Phone: 330-948-5502 Fax: 330-948-3645 |