| Montgomery Family Practice, Inc | |
|
10550 Montgomery Rd Ste 11 Montgomery OH 45242-4495 | |
| (513) 791-1201 | |
| (513) 791-1231 |
| Full Name | Montgomery Family Practice, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 10550 Montgomery Rd Ste 11, Montgomery, Ohio |
| Authorized Official Name and Position | Ginger S Kubala (PRESIDENT MD) |
| Authorized Official Contact | 5137911201 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Montgomery Family Practice, Inc 10550 Montgomery Rd # 12 Cincinnati OH 45242 Ph: (513) 791-1201 | Montgomery Family Practice, Inc 10550 Montgomery Rd Ste 11 Montgomery OH 45242-4495 Ph: (513) 791-1201 |
| NPI Number | 1144390345 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 01/11/2023 |
| Medicare PECOS PAC ID | 6709974165 |
|---|---|
| Medicare Enrollment ID | O20071119000194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144390345 | NPI | - | NPPES |
| 2274891 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35057045 (Ohio) | Secondary |
| 207Q00000X | Family Medicine | 35067638 (Ohio) | Secondary |
| 207Q00000X | Family Medicine | 350728718 (Ohio) | Primary |
| Provider Name | Ginger S Kubala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952441891 PECOS PAC ID: 3375632151 Enrollment ID: I20071130000547 |
| Provider Name | William R Cox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902946858 PECOS PAC ID: 0840467320 Enrollment ID: I20120124000773 |
| Provider Name | Anthony W Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417097361 PECOS PAC ID: 5698932614 Enrollment ID: I20120202000777 |
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