| West Carrollton Family Medicine | |
|
100 Elmwood Park Dr Suite 202 West Carrollton OH 45449-5402 | |
| (937) 847-7406 | |
| (937) 847-7427 |
| Full Name | West Carrollton Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 100 Elmwood Park Dr, West Carrollton, Ohio |
| Authorized Official Name and Position | Kenneth Prunier (PRESIDENT/CEO) |
| Authorized Official Contact | 9372088213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Carrollton Family Medicine 100 Elmwood Park Dr Suite 202 West Carrollton OH 45449-5402 Ph: (937) 847-7406 | West Carrollton Family Medicine 100 Elmwood Park Dr Suite 202 West Carrollton OH 45449-5402 Ph: (937) 847-7406 |
| NPI Number | 1528291457 |
|---|---|
| Provider Enumeration Date | 08/26/2009 |
| Last Update Date | 11/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528291457 | NPI | - | NPPES |
| 0057448 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Miamisburg Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1625 S Alex Rd, West Carrollton, OH 45449 Phone: 937-865-0534 Fax: 937-865-0721 |