| Bellbrook Family Practice | |
|
6438 Wilmington Pike Suite110 Centerville OH 45459-7010 | |
| (937) 848-4121 | |
| (937) 848-5965 |
| Full Name | Bellbrook Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 6438 Wilmington Pike, Centerville, Ohio |
| Authorized Official Name and Position | John Murphy (PHYSICIAN) |
| Authorized Official Contact | 9378484121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bellbrook Family Practice 6438 Wilmington Pike Suite110 Centerville OH 45459-7010 Ph: (937) 848-4121 | Bellbrook Family Practice 6438 Wilmington Pike Suite110 Centerville OH 45459-7010 Ph: (937) 848-4121 |
| NPI Number | 1174627657 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 08/12/2013 |
| Medicare PECOS PAC ID | 3274684766 |
|---|---|
| Medicare Enrollment ID | O20090623000452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174627657 | NPI | - | NPPES |
| 2516450 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Carissa Sue Haines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346591815 PECOS PAC ID: 1557645355 Enrollment ID: I20170608001101 |
| Provider Name | Kimbra L Joyce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033525589 PECOS PAC ID: 0143543124 Enrollment ID: I20180727002561 |
| Provider Name | Katrina Burgos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023665619 PECOS PAC ID: 1355673658 Enrollment ID: I20191105001683 |
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