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OAK CREEK OBGYN NPI 1417058314


NPI Information

NPI: 1417058314
Provider Name: OAK CREEK OBGYN
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 36D1033669

Address:
2510 COMMONS BLVD
SUITE 270
BEAVERCREEK, OH
ZIP 45431
Phone: (937) 431-0200
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OAK CREEK OBGYN is an obstetrics gynecology in Beavercreek, OH. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. OAK CREEK OBGYN NPI is 1417058314. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2510 COMMONS BLVD
SUITE 270
BEAVERCREEK, OH
ZIP 45431-820
Phone: (937) 431-0200
Fax: (937) 431-0488

The provider's authorized official is William Michael Mccullough .
The authorized official title is Senior Physician Of Practice and has the following contact phone number (937) 848-4850.

The CLIA number assigned to this NPI record is 36D1033669 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/26/2006 and was last updated on 8/12/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & GynecologyYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1OA9294871MEDICARE PINOHIO

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: 4/28/2024

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