| Raymond D Wolf D.o. Inc. | |
|
1 Marty Ln West Alexandria OH 45381-1165 | |
| (937) 839-4681 | |
| (937) 839-1126 |
| Full Name | Raymond D Wolf D.o. Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 Marty Ln, West Alexandria, Ohio |
| Authorized Official Name and Position | Raymond D Wolf (SOLE PROPRIETOR) |
| Authorized Official Contact | 9378394681 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Raymond D Wolf D.o. Inc. 1 Marty Ln West Alexandria OH 45381-1165 Ph: (937) 839-4681 | Raymond D Wolf D.o. Inc. 1 Marty Ln West Alexandria OH 45381-1165 Ph: (937) 839-4681 |
| NPI Number | 1881965028 |
|---|---|
| Provider Enumeration Date | 01/19/2012 |
| Last Update Date | 01/19/2012 |
| Medicare PECOS PAC ID | 6608097175 |
|---|---|
| Medicare Enrollment ID | O20141027000752 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881965028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 34-00-4358-W (Ohio) | Primary |
| Provider Name | Raymond Desmond Wolf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023037397 PECOS PAC ID: 7315035805 Enrollment ID: I20071116000419 |
Twin Valley Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 60 W Dayton St, West Alexandria, OH 45381 Phone: 937-839-8837 Fax: 937-839-0408 |