Provider Demographics
NPI:1194736140
Name:DOCTORS PRIMARY CARE - HILLIARD, INC
Entity type:Organization
Organization Name:DOCTORS PRIMARY CARE - HILLIARD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAVELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-367-1679
Mailing Address - Street 1:5548 HILLIARD ROME OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7286
Mailing Address - Country:US
Mailing Address - Phone:614-850-9311
Mailing Address - Fax:614-850-9314
Practice Address - Street 1:5548 HILLIARD ROME OFFICE PARK
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7286
Practice Address - Country:US
Practice Address - Phone:614-850-9311
Practice Address - Fax:614-850-9314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2585911Medicaid
OH2585911Medicaid