| Richard G Wise Do Inc | |
|
11 Sycamore Drive New Middletown OH 44442 | |
| (330) 542-2881 | |
| (330) 542-0074 |
| Full Name | Richard G Wise Do Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11 Sycamore Drive, New Middletown, Ohio |
| Authorized Official Name and Position | Richard G Wise (PRESIDENT) |
| Authorized Official Contact | 3305422881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard G Wise Do Inc Po Box 272 New Middletown OH 44442-0272 Ph: (330) 542-2881 | Richard G Wise Do Inc 11 Sycamore Drive New Middletown OH 44442 Ph: (330) 542-2881 |
| NPI Number | 1164601746 |
|---|---|
| Provider Enumeration Date | 10/30/2007 |
| Last Update Date | 11/08/2007 |
| Medicare PECOS PAC ID | 4183819600 |
|---|---|
| Medicare Enrollment ID | O20101110000703 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164601746 | NPI | - | NPPES |
| 0598769 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 34003728 (Ohio) | Primary |
| Provider Name | Richard George Wise |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386610236 PECOS PAC ID: 5092900514 Enrollment ID: I20101110000719 |
Dr Robert Hendricks Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10251 Main Street, New Middletown, OH 44442 Phone: 330-542-2315 Fax: 330-542-9700 |