| Mound Family Practice | |
|
1012 E Central Ave Miamisburg OH 45342-2556 | |
| (937) 866-0741 | |
| (937) 866-8861 |
| Full Name | Mound Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 1012 E Central Ave, Miamisburg, Ohio |
| Authorized Official Name and Position | Daniel D Haibach (DIRECTOR BUSINESS DEVELOPMENT) |
| Authorized Official Contact | 9375583222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mound Family Practice 2110 Leiter Rd Miamisburg OH 45342-3660 Ph: (937) 384-4838 | Mound Family Practice 1012 E Central Ave Miamisburg OH 45342-2556 Ph: (937) 866-0741 |
| NPI Number | 1659653962 |
|---|---|
| Provider Enumeration Date | 09/13/2011 |
| Last Update Date | 09/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659653962 | NPI | - | NPPES |
| 2712872 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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