| Organization Name: | HOCKING VALLEY MEDICAL GROUP, INC. |
| NPI Number: | 1801994827 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LETHA JEAN HEFT (ASSISTANT PRACTICE MANAGER) |
| Mailing Address: | 819 State Route 664 N Suite A & B Logan |
| State: | OH US |
| Postal Code: | 431388540 |
| Phone Number: | 7403850202 |
| Fax Number: | 7403850505 |
| NPI Enumeration Date: | 09/21/2006 |
| NPI Last Update Date: | 05/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |