| Mid Ohio Medical Management,llc | |
|
1755 Lancaster Ave Reynoldsburg OH 43068 | |
| (614) 834-7030 | |
| (614) 834-7032 |
| Full Name | Mid Ohio Medical Management,llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1755 Lancaster Ave, Reynoldsburg, Ohio |
| Authorized Official Name and Position | Gina Marie Nichols (CEO) |
| Authorized Official Contact | 6148347030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid Ohio Medical Management,llc Po Box 513 Pickerington OH 43147-0513 Ph: (614) 834-7030 | Mid Ohio Medical Management,llc 1755 Lancaster Ave Reynoldsburg OH 43068 Ph: (614) 834-7030 |
| NPI Number | 1497916605 |
|---|---|
| Provider Enumeration Date | 06/19/2008 |
| Last Update Date | 05/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497916605 | NPI | - | NPPES |
| 2611267 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35086704 (Ohio) | Primary |
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