| |
1525 E Stroop Rd Suite 200 Kettering OH 45429-5065 | |
(937) 208-7400 | |
(937) 208-7405 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 1525 E Stroop Rd, Kettering, Ohio |
Authorized Official Name and Position | Kenneth Prunier (CEO/PRESIDENT) |
Authorized Official Contact | 9372088213 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1525 E Stroop Rd Suite 200 Kettering OH 45429-5065 Ph: (937) 208-7400 | 1525 E Stroop Rd Suite 200 Kettering OH 45429-5065 Ph: (937) 208-7400 |
NPI Number | 1922051994 |
---|---|
Provider Enumeration Date | 05/18/2006 |
Last Update Date | 08/27/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922051994 | NPI | - | NPPES |
0160169 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Kevin G Malloy Md, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5250 Far Hills Ave, Ste 250, Kettering, OH 45429 Phone: 937-435-6500 Fax: 937-435-6514 | |
Post Acute Solutions, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1251 E Dorothy Ln, Suite A, Kettering, OH 45419 Phone: 513-575-6325 Fax: 937-853-0552 | |
Infectious Diseases Associates Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3533 Southern Blvd Ste 4200, Kettering, OH 45429 Phone: 937-572-7648 Fax: 937-832-8279 | |
Fred L Tanzer Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4750 Hempstead Station Dr, Kettering, OH 45429 Phone: 513-543-3746 Fax: 513-557-3347 |