| Macke Family Practice Llc | |
|
1025 Fair Rd Sidney OH 45365-8947 | |
| (937) 492-1352 | |
| (937) 492-1353 |
| Full Name | Macke Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1025 Fair Rd, Sidney, Ohio |
| Authorized Official Name and Position | Dawn Diane Macke (NURSE PRACTITIONER) |
| Authorized Official Contact | 9374921352 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Macke Family Practice Llc 1025 Fair Rd Sidney OH 45365-8947 Ph: (937) 492-1352 | Macke Family Practice Llc 1025 Fair Rd Sidney OH 45365-8947 Ph: (937) 492-1352 |
| NPI Number | 1730816810 |
|---|---|
| Provider Enumeration Date | 08/08/2022 |
| Last Update Date | 09/28/2022 |
| Medicare PECOS PAC ID | 5395113997 |
|---|---|
| Medicare Enrollment ID | O20221201000597 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730816810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dawn Macke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336512672 PECOS PAC ID: 9234430406 Enrollment ID: I20151211000829 |
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