| London Family Medicine, Inc. | |
|
55 Park Ave Suite 230 London OH 43140-1121 | |
| (740) 845-7600 | |
| (740) 845-7676 |
| Full Name | London Family Medicine, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 55 Park Ave, London, Ohio |
| Authorized Official Name and Position | Steven G Richardson (OWNER) |
| Authorized Official Contact | 7408457600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| London Family Medicine, Inc. 1550 S 70th St Ste 202 Po Box 67250 Lincoln NE 68506-1576 Ph: (402) 328-8833 | London Family Medicine, Inc. 55 Park Ave Suite 230 London OH 43140-1121 Ph: (740) 845-7600 |
| NPI Number | 1174582530 |
|---|---|
| Provider Enumeration Date | 03/22/2006 |
| Last Update Date | 11/25/2009 |
| Medicare PECOS PAC ID | 7416978010 |
|---|---|
| Medicare Enrollment ID | O20051212000110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174582530 | NPI | - | NPPES |
| 000000286657 | Other | OH | ANTHEM BCBS |
| DF3030 | Other | OH | RRM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lori Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548672637 PECOS PAC ID: 8426274614 Enrollment ID: I20140724000527 |
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