FREDERICKTOWN FAMILY PRACTICE NPI 1114060472

NPI Information

  • NPI: 1114060472
  • Provider Name: FREDERICKTOWN FAMILY PRACTICE
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 16361 VILLAGE PKWY
    FREDERICKTOWN, OH
    ZIP 43019
  • Phone: (740) 694-2110

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NPI Details

FREDERICKTOWN FAMILY PRACTICE is a family medicine in Fredericktown, OH. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FREDERICKTOWN FAMILY PRACTICE NPI is 1114060472. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

16361 VILLAGE PKWY
FREDERICKTOWN, OH
ZIP 43019-585
Phone: (740) 694-2110
Fax: (740) 694-2127

The provider's authorized official is Amanda Bowers .
The authorized official title is Office Manager and has the following contact phone number (740) 694-2110.

The enumeration date for this NPI number is 2/15/2007 and was last updated on 7/20/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12161191MEDICAIDOHIO
2FR9307321MEDICARE ID-TYPE UNSPECIFIEDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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