| Village Green Primary Care | |
|
945 Deis Dr Fairfield OH 45014-8130 | |
| (513) 858-2666 | |
| (513) 858-2685 |
| Full Name | Village Green Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 945 Deis Dr, Fairfield, Ohio |
| Authorized Official Name and Position | Timothy Y Ko (CFO) |
| Authorized Official Contact | 9375583223 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Village Green Primary Care 2110 Leiter Rd Miamisburg OH 45342-3660 Ph: (937) 384-4838 | Village Green Primary Care 945 Deis Dr Fairfield OH 45014-8130 Ph: (513) 858-2666 |
| NPI Number | 1922355999 |
|---|---|
| Provider Enumeration Date | 08/09/2012 |
| Last Update Date | 10/04/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922355999 | NPI | - | NPPES |
| 0070182 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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