| New Phoenix Llc | |
|
3533 Southern Blvd Ste 3000 Kettering OH 45429-1280 | |
| (937) 299-8242 | |
| (937) 299-8245 |
| Full Name | New Phoenix Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3533 Southern Blvd, Kettering, Ohio |
| Authorized Official Name and Position | James Eugene Foster (OWNER/PRESIDENT) |
| Authorized Official Contact | 9372998242 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Phoenix Llc 11161 Ashbury Meadows Dr Dayton OH 45458-6403 Ph: () - | New Phoenix Llc 3533 Southern Blvd Ste 3000 Kettering OH 45429-1280 Ph: (937) 299-8242 |
| NPI Number | 1922381672 |
|---|---|
| Provider Enumeration Date | 09/20/2011 |
| Last Update Date | 01/19/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922381672 | NPI | - | NPPES |
| H027071 | Other | OH | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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