| Western Medicine, Inc. | |
|
7774 Dayton Springfield Rd Fairborn OH 45324-1957 | |
| (937) 864-7363 | |
| (937) 864-5895 |
| Full Name | Western Medicine, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 7774 Dayton Springfield Rd, Fairborn, Ohio |
| Authorized Official Name and Position | Jacob Thomas Dean (OWNER) |
| Authorized Official Contact | 9378647363 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Medicine, Inc. Po Box 339 Enon OH 45323-0339 Ph: (937) 864-7363 | Western Medicine, Inc. 7774 Dayton Springfield Rd Fairborn OH 45324-1957 Ph: (937) 864-7363 |
| NPI Number | 1912970468 |
|---|---|
| Provider Enumeration Date | 02/07/2006 |
| Last Update Date | 08/07/2019 |
| Medicare PECOS PAC ID | 1052363967 |
|---|---|
| Medicare Enrollment ID | O20050218000095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912970468 | NPI | - | NPPES |
| 2632593 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35081458 (Ohio) | Primary |
| Provider Name | Jacob T Dean |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932172467 PECOS PAC ID: 6507751773 Enrollment ID: I20040217000535 |
| Provider Name | Aaron Thomas Groth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508809021 PECOS PAC ID: 1850395781 Enrollment ID: I20060908000065 |
| Provider Name | Gary M Onady |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396792347 PECOS PAC ID: 1951300227 Enrollment ID: I20061214000187 |
| Provider Name | Jennifer L Machuca |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669694246 PECOS PAC ID: 9537224654 Enrollment ID: I20090224000314 |
| Provider Name | Jennifer M Dyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326279373 PECOS PAC ID: 7416095658 Enrollment ID: I20151005001149 |
| Provider Name | Shelli Ann Ridge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356629356 PECOS PAC ID: 1658680715 Enrollment ID: I20151013000352 |
| Provider Name | Sarah Rodewald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821443664 PECOS PAC ID: 1658655980 Enrollment ID: I20170303001489 |
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