Waterstreet Family Practice, Inc.

LBN: Waterstreet Family Practice, Inc.
Waterstreet Family Practice, Inc. is an health care organization with primary practice located at 1162 N Monroe Dr , Xenia OH 45385-1620. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as the primary health care specialty. Waterstreet Family Practice, Inc. can be contacted via phone (937) 374-6450, or through Hogan, Penny Sue via phone (937) 374-6450.

Contact Information

Primary practice address
1162 N Monroe Dr Xenia OH 45385-1620
Phone: (937) 374-6450
Fax: (937) 374-6455
Website:
Map and Directions
Authorized official contact:
Name: Hogan, Penny Sue Doctor of Medicine (MD)
Phone: (937) 374-6450

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 35071125H Ohio

Profile Details

NPI number 1831300862
LBN Legal business name Waterstreet Family Practice, Inc.
DBA Doing business as
Authorized official Hogan, Penny Sue Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 24th, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831300862 NPPES
Ohio MEDICAID 2150032

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