| Kettering Health Medical Group Primary Care | |
|
415 Byers Rd Suite 300 Miamisburg OH 45342-3696 | |
| (937) 866-2494 | |
| (937) 866-8494 |
| Full Name | Kettering Health Medical Group Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 415 Byers Rd, Miamisburg, Ohio |
| Authorized Official Name and Position | Timothy Y Ko (CFO) |
| Authorized Official Contact | 9375583223 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kettering Health Medical Group Primary Care 1 Prestige Pl Ste 550 Miamisburg OH 45342-6115 Ph: (937) 762-1310 | Kettering Health Medical Group Primary Care 415 Byers Rd Suite 300 Miamisburg OH 45342-3696 Ph: (937) 866-2494 |
| NPI Number | 1811121619 |
|---|---|
| Provider Enumeration Date | 05/07/2009 |
| Last Update Date | 01/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811121619 | NPI | - | NPPES |
| 3011118 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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