Provider Demographics
NPI:1285753749
Name:FAMILY PHYSICIANS OF URBANA INC
Entity type:Organization
Organization Name:FAMILY PHYSICIANS OF URBANA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-652-1834
Mailing Address - Street 1:900 SCIOTO ST
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-2251
Mailing Address - Country:US
Mailing Address - Phone:937-652-1834
Mailing Address - Fax:937-653-3476
Practice Address - Street 1:900 SCIOTO ST
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-2251
Practice Address - Country:US
Practice Address - Phone:937-652-1834
Practice Address - Fax:937-653-3476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty