| Pandora Family Physicians, Inc. | |
|
202 Hilty Drive Pandora OH 45877-9703 | |
| (419) 384-3251 | |
| (419) 384-3269 |
| Full Name | Pandora Family Physicians, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 202 Hilty Drive, Pandora, Ohio |
| Authorized Official Name and Position | David L Woodruff (VP) |
| Authorized Official Contact | 4193843251 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pandora Family Physicians, Inc. 202 Hilty Drive Po Box 299 Pandora OH 45877-0299 Ph: (419) 384-3251 | Pandora Family Physicians, Inc. 202 Hilty Drive Pandora OH 45877-9703 Ph: (419) 384-3251 |
| NPI Number | 1770564387 |
|---|---|
| Provider Enumeration Date | 11/10/2005 |
| Last Update Date | 08/10/2022 |
| Medicare PECOS PAC ID | 8123001963 |
|---|---|
| Medicare Enrollment ID | O20040611000401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770564387 | NPI | - | NPPES |
| 0581517 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lance P Criblez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174519342 PECOS PAC ID: 5597662650 Enrollment ID: I20031217000031 |
| Provider Name | Steven K Mccullough |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992791925 PECOS PAC ID: 4981745510 Enrollment ID: I20100105000419 |
| Provider Name | David Woodruff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154317188 PECOS PAC ID: 1658358874 Enrollment ID: I20100105000506 |
| Provider Name | Kimberly A Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205457595 PECOS PAC ID: 3375962467 Enrollment ID: I20200923000211 |
| Provider Name | Jill Catherine Horner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346904927 PECOS PAC ID: 7315337722 Enrollment ID: I20211129001351 |