| Organization Name: | GENESIS MEDICAL GROUP LLC |
| NPI Number: | 1063663433 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAUL D MASTERSON (ASSIST. TREASURER) |
| Mailing Address: | 945 Bethesda Dr Ste 200 Zanesville |
| State: | OH US |
| Postal Code: | 437011880 |
| Phone Number: | 7404506147 |
| Fax Number: | |
| NPI Enumeration Date: | 10/03/2008 |
| NPI Last Update Date: | 12/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207KA0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Allergy & Immunology |
| Taxonomy Specialization: | Allergy |
| Taxonomy Definition: | |