| Phillip B. Doudna, D.c., Llc | |
|
4305 Broadway Grove City OH 43123-3017 | |
| (614) 875-1121 | |
| (614) 875-1111 |
| Full Name | Phillip B. Doudna, D.c., Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4305 Broadway, Grove City, Ohio |
| Authorized Official Name and Position | Phillip B. Doudna (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 6148751121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phillip B. Doudna, D.c., Llc 4305 Broadway Grove City OH 43123-3017 Ph: (614) 875-1121 | Phillip B. Doudna, D.c., Llc 4305 Broadway Grove City OH 43123-3017 Ph: (614) 875-1121 |
| NPI Number | 1033395439 |
|---|---|
| Provider Enumeration Date | 01/15/2008 |
| Last Update Date | 09/09/2008 |
| Medicare PECOS PAC ID | 9537235296 |
|---|---|
| Medicare Enrollment ID | O20080903000274 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033395439 | NPI | - | NPPES |
| 0877538 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1397 (Ohio) | Primary |
| Provider Name | Phillip B Doudna |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1346265493 PECOS PAC ID: 3274609037 Enrollment ID: I20080903000263 |
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