| Southmoor Medical Associates | |
|
38 Southmoor Cir Ne Kettering OH 45429-2443 | |
| (937) 294-4487 | |
| (937) 294-2255 |
| Full Name | Southmoor Medical Associates |
|---|---|
| Speciality | Family Medicine |
| Location | 38 Southmoor Cir Ne, Kettering, Ohio |
| Authorized Official Name and Position | John Jerome Hochwalt (PRESIDENT) |
| Authorized Official Contact | 9372944487 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southmoor Medical Associates 38 Southmoor Cir Ne Kettering OH 45429-2443 Ph: (937) 294-4487 | Southmoor Medical Associates 38 Southmoor Cir Ne Kettering OH 45429-2443 Ph: (937) 294-4487 |
| NPI Number | 1336264209 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 08/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336264209 | NPI | - | NPPES |
| 0198772 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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