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540 Lincoln Park Blvd Suite 200 Kettering OH 45429-6401 | |
(937) 293-1117 | |
(937) 298-4728 |
Full Name | |
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Speciality | Internal Medicine |
Location | 540 Lincoln Park Blvd, Kettering, Ohio |
Authorized Official Name and Position | Mark A Couch (PRESIDENT) |
Authorized Official Contact | 9378983600 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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25 Merchant St Ste 220 - Attn Credentialing Cincinnati OH 45246-3740 Ph: (513) 533-1199 | 540 Lincoln Park Blvd Suite 200 Kettering OH 45429-6401 Ph: (937) 293-1117 |
NPI Number | 1578521449 |
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Provider Enumeration Date | 05/02/2006 |
Last Update Date | 07/15/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578521449 | NPI | - | NPPES |
CA2478 | Other | MEDICARE RR GROUP NUMBER | |
3006553 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Kevin G Malloy Md, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5250 Far Hills Ave, Ste 250, Kettering, OH 45429 Phone: 937-435-6500 Fax: 937-435-6514 | |
Post Acute Solutions, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1251 E Dorothy Ln, Suite A, Kettering, OH 45419 Phone: 513-575-6325 Fax: 937-853-0552 | |
Infectious Diseases Associates Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3533 Southern Blvd Ste 4200, Kettering, OH 45429 Phone: 937-572-7648 Fax: 937-832-8279 | |
Fred L Tanzer Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4750 Hempstead Station Dr, Kettering, OH 45429 Phone: 513-543-3746 Fax: 513-557-3347 |