Provider Demographics
NPI:1114664836
Name:OHIO VALLEY MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:OHIO VALLEY MEDICAL GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:R
Authorized Official - Last Name:REEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-340-6444
Mailing Address - Street 1:2816 TROY RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-4328
Mailing Address - Country:US
Mailing Address - Phone:937-340-6440
Mailing Address - Fax:937-340-6441
Practice Address - Street 1:7790 DAYTON SPRINGFIELD RD STE B
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-1996
Practice Address - Country:US
Practice Address - Phone:937-340-6440
Practice Address - Fax:937-340-6441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-14
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty