Enoch, Archie D

Enoch, Archie D is an individual health care provider with primary practice located at 4172 Indian Ripple Rd Ste A , Beavercreek OH 45440-3286. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Enoch, Archie D can be contacted via phone (937) 431-3779.

Contact Information

Primary practice address
4172 Indian Ripple Rd Ste A Beavercreek OH 45440-3286
Phone: (937) 431-3779
Fax: (937) 431-3776
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35065803 Ohio

Profile Details

NPI number 1780683755
LBN Legal business name Enoch, Archie D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2005
Last updated Jan 12th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780683755 NPPES
Illinois MEDICAID 0360899251
Illinois MEDICAID 0079514

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