Organization Name: | AFTER HOURS FAMILY MEDICINE LLC |
NPI Number: | 1770804551 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DORA RICHARDSON (PROVIDER) |
Mailing Address: | 18 E Main St Seville |
State: | OH US |
Postal Code: | 442738850 |
Phone Number: | 3309754255 |
Fax Number: | 3309754277 |
NPI Enumeration Date: | 06/16/2010 |
NPI Last Update Date: | 08/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | NP04192 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |