| Upper Sandusky Medical Assoc Inc | |
|
777 N Sandusky Ave Upper Sandusky OH 43351-1075 | |
| (419) 294-2375 | |
| (419) 294-2412 |
| Full Name | Upper Sandusky Medical Assoc Inc |
|---|---|
| Speciality | General Practice |
| Location | 777 N Sandusky Ave, Upper Sandusky, Ohio |
| Authorized Official Name and Position | Konstantine K Solacoff (CORPORATION PRESIDENT) |
| Authorized Official Contact | 4192942375 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upper Sandusky Medical Assoc Inc 777 N Sandusky Ave Upper Sandusky OH 43351-1075 Ph: (419) 294-2375 | Upper Sandusky Medical Assoc Inc 777 N Sandusky Ave Upper Sandusky OH 43351-1075 Ph: (419) 294-2375 |
| NPI Number | 1215936075 |
|---|---|
| Provider Enumeration Date | 07/14/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215936075 | NPI | - | NPPES |
| 0423652 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (Ohio) | Primary |
Wyandot Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 245 Tarhe Trl, Upper Sandusky, OH 43351 Phone: 419-294-1525 Fax: 419-209-0252 | |
Kyu Park Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Houpt Dr, Upper Sandusky, OH 43351 Phone: 419-294-5757 Fax: 419-209-0623 |