| Southland Family Medicine Associates Inc | |
|
03920 Southland Rd New Bremen OH 45869 | |
| (419) 629-2772 | |
| (419) 629-3613 |
| Full Name | Southland Family Medicine Associates Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 03920 Southland Rd, New Bremen, Ohio |
| Authorized Official Name and Position | Victor J Stegall (DIRECTOR) |
| Authorized Official Contact | 4196292772 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southland Family Medicine Associates Inc 03920 Southland Rd Po Box 127 New Bremen OH 45869 Ph: (419) 629-2772 | Southland Family Medicine Associates Inc 03920 Southland Rd New Bremen OH 45869 Ph: (419) 629-2772 |
| NPI Number | 1801976311 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 01/27/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801976311 | NPI | - | NPPES |
| 0995811 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35 03 2392 S (Ohio) | Primary |
| 207Q00000X | Family Medicine | 35 04 8500 L (Ohio) | Secondary |
| 207Q00000X | Family Medicine | 35 02 4908 B (Ohio) | Secondary |