| Medical South Family Practice | |
|
330 N Main St Centerville OH 45459-4465 | |
| (937) 433-0960 | |
| (937) 433-0958 |
| Full Name | Medical South Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 330 N Main St, Centerville, Ohio |
| Authorized Official Name and Position | Kenneth Prunier (CEO/PRESIDENT) |
| Authorized Official Contact | 9374998205 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical South Family Practice 330 N Main St Centerville OH 45459-4465 Ph: (937) 433-0960 | Medical South Family Practice 330 N Main St Centerville OH 45459-4465 Ph: (937) 433-0960 |
| NPI Number | 1912310400 |
|---|---|
| Provider Enumeration Date | 06/03/2014 |
| Last Update Date | 06/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912310400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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