Provider Demographics
NPI:1073508354
Name:FORD, MELINDA E (DO)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:E
Last Name:FORD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:5450 FRANTZ RD STE 360
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4141
Mailing Address - Country:US
Mailing Address - Phone:614-544-6155
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:24 W GREEN DR STE 246
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2974
Practice Address - Country:US
Practice Address - Phone:740-593-2516
Practice Address - Fax:740-593-2905
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2019-12-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34008230207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I33118Medicare UPIN