Mark, Milford, Hicksville Joint Township Hospital District | |
208 Columbus Street Hicksville OH 43526 | |
(419) 542-6692 | |
(419) 542-6506 |
Full Name | Mark, Milford, Hicksville Joint Township Hospital District |
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Speciality | General Acute Care Hospital |
Location | 208 Columbus Street, Hicksville, Ohio |
Authorized Official Name and Position | Jane Zachrich (CEO) |
Authorized Official Contact | 4195425566 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mark, Milford, Hicksville Joint Township Hospital District 208 Columbus Street Hicksville OH 43526 Ph: (419) 542-6692 | Mark, Milford, Hicksville Joint Township Hospital District 208 Columbus Street Hicksville OH 43526 Ph: (419) 542-6692 |
NPI Number | 1730145392 |
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Provider Enumeration Date | 04/24/2006 |
Last Update Date | 08/07/2019 |
Medicare PECOS PAC ID | 0547258907 |
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Medicare Enrollment ID | O20040504000912 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730145392 | NPI | - | NPPES |
1677841 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
282NC0060X | General Acute Care Hospital - Critical Access | (* (Not Available)) | Primary |
Provider Name | Daniel J Hoffman |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1669464376 PECOS PAC ID: 5799689857 Enrollment ID: I20031121000069 |
Provider Name | James B Emerson |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1538155544 PECOS PAC ID: 9133023070 Enrollment ID: I20031121000889 |
Provider Name | Seth A Rosenberg |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1144313164 PECOS PAC ID: 8022910439 Enrollment ID: I20040126000407 |
Provider Name | Pantelhs Pete Varlas |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1134156250 PECOS PAC ID: 8123000718 Enrollment ID: I20040607000649 |
Provider Name | Scott A Waters |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1235233867 PECOS PAC ID: 6507778966 Enrollment ID: I20040610001370 |
Provider Name | Kamran Rafiq |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1942395546 PECOS PAC ID: 7517945009 Enrollment ID: I20040712000207 |
Provider Name | Robert E Barnett |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1033102918 PECOS PAC ID: 6002882081 Enrollment ID: I20040909001463 |
Provider Name | Lori Lynn Hockenberry |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1407840721 PECOS PAC ID: 0042274102 Enrollment ID: I20041117001206 |
Provider Name | Rowland J Rivero |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1154530368 PECOS PAC ID: 4688630841 Enrollment ID: I20041209000019 |
Provider Name | Marcus Ma |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1336102847 PECOS PAC ID: 2961315072 Enrollment ID: I20050228001051 |
Provider Name | Kirk D Crouser |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1972501997 PECOS PAC ID: 1759328131 Enrollment ID: I20050421001287 |
Provider Name | Kathryn S Watson |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1417031733 PECOS PAC ID: 5799723474 Enrollment ID: I20050422000342 |
Provider Name | David P Rickson |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1376573899 PECOS PAC ID: 0042252496 Enrollment ID: I20050525000769 |
Provider Name | Anthony G Vlastaris |
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Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1124074364 PECOS PAC ID: 2163466509 Enrollment ID: I20050616000007 |
Provider Name | John R Desmarais |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1023085834 PECOS PAC ID: 7214955798 Enrollment ID: I20051103000134 |
Provider Name | John J Wukie |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1588767883 PECOS PAC ID: 4688671050 Enrollment ID: I20061107000150 |
Provider Name | Jeffrey L Justice |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1770584377 PECOS PAC ID: 4789674433 Enrollment ID: I20070130000520 |
Provider Name | Matthew C Grothaus |
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Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1417978776 PECOS PAC ID: 9032118138 Enrollment ID: I20071113000491 |
Provider Name | Michael Kooistra |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508864380 PECOS PAC ID: 8527166719 Enrollment ID: I20071127000866 |
Provider Name | Francis K Aona |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982768255 PECOS PAC ID: 6204917404 Enrollment ID: I20080114000617 |
Provider Name | Craig E Hanson |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1578600565 PECOS PAC ID: 6608886874 Enrollment ID: I20080327000470 |
Provider Name | Patricia Mattevi |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1487739157 PECOS PAC ID: 0143399394 Enrollment ID: I20080514000627 |
Provider Name | Johnathan R Haggerty |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1770744617 PECOS PAC ID: 8628144029 Enrollment ID: I20080909000535 |
Provider Name | David Cheng |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1114960630 PECOS PAC ID: 9032116330 Enrollment ID: I20080922000164 |
Provider Name | Todd M Wiley |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1295838134 PECOS PAC ID: 7416000526 Enrollment ID: I20090806000158 |
Provider Name | Duane Johnson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750392676 PECOS PAC ID: 7517042880 Enrollment ID: I20090818000427 |
Provider Name | Laverne L Miller |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1477549962 PECOS PAC ID: 0749320216 Enrollment ID: I20091214000378 |
Provider Name | James H Gray |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1902903230 PECOS PAC ID: 7911804018 Enrollment ID: I20100419000020 |
Provider Name | Kathryn A Khandaker |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417254764 PECOS PAC ID: 0749464436 Enrollment ID: I20110404000750 |
Provider Name | Jian Cui |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1639338940 PECOS PAC ID: 1759422116 Enrollment ID: I20111005000720 |
Provider Name | Jessica L Slattery |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245518927 PECOS PAC ID: 9537331608 Enrollment ID: I20111013000643 |
Provider Name | Laurie A Barkway |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1003870031 PECOS PAC ID: 9133195506 Enrollment ID: I20120223000345 |
Provider Name | Vasavi K Reddy |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1356580294 PECOS PAC ID: 3274658034 Enrollment ID: I20120608000178 |
Provider Name | Gabrielle F Morris |
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Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1912937459 PECOS PAC ID: 6204804925 Enrollment ID: I20140129002004 |
Provider Name | Tara L Garza |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598165888 PECOS PAC ID: 3678794823 Enrollment ID: I20141031001517 |
Provider Name | Jeffrey Allen Bender |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1881618205 PECOS PAC ID: 6406859172 Enrollment ID: I20141212001337 |
Provider Name | Ricardo G Joseph |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1750342135 PECOS PAC ID: 7911907902 Enrollment ID: I20160203001489 |
Provider Name | Richard Walter Pretorius |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1013900505 PECOS PAC ID: 4688561517 Enrollment ID: I20161004000765 |
Provider Name | Meghan E Wooster |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1710305628 PECOS PAC ID: 1052691789 Enrollment ID: I20161214002269 |
Provider Name | Ryan K Bleck |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1568877546 PECOS PAC ID: 3779701123 Enrollment ID: I20170616001861 |
Provider Name | Megan E Ashbacher |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124544614 PECOS PAC ID: 5395001317 Enrollment ID: I20171108000718 |
Provider Name | Jessica J Mendez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831445055 PECOS PAC ID: 6608008735 Enrollment ID: I20180724000259 |
Provider Name | Ellise S Koenn |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952897092 PECOS PAC ID: 8527317692 Enrollment ID: I20180822002780 |
Provider Name | Crystal Trabel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912480039 PECOS PAC ID: 8820341340 Enrollment ID: I20181031001753 |
Provider Name | Conner Yoder |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1275090094 PECOS PAC ID: 2961743612 Enrollment ID: I20190408001471 |
Provider Name | Michael C Tiller |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1114345378 PECOS PAC ID: 5597046573 Enrollment ID: I20191015001551 |
Provider Name | Jeanne Bohm |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982915138 PECOS PAC ID: 0244474948 Enrollment ID: I20200521003157 |
Provider Name | Elizabeth A Heitmeyer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104455344 PECOS PAC ID: 9830511484 Enrollment ID: I20200626002168 |
Provider Name | Satinderjit Singh |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1013203199 PECOS PAC ID: 1759525397 Enrollment ID: I20210715004098 |
Provider Name | Alisha D Hudson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639750524 PECOS PAC ID: 8022416023 Enrollment ID: I20211005003364 |
Provider Name | Stephanie R Ramey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811661895 PECOS PAC ID: 2264820091 Enrollment ID: I20211028001373 |
Provider Name | Akhter Saeed |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1699783340 PECOS PAC ID: 8921236449 Enrollment ID: I20230309000525 |
Hicksville Family Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 208 Columbus St, Hicksville, OH 43526 Phone: 419-542-6692 |