| NPI | 1801994827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY BROWN Credentialing Specialist 740-380-8350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 208000000X Pediatrics | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 208600000X Surgery | |
| 208D00000X General Practice | |
| 363A00000X Physician Assistant | |
| 363AS0400X Physician Assistant, Surgical | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2025-08-20 |