Provider Demographics
NPI:1093842858
Name:READING FAMILY PRACTICE, LLC
Entity Type:Organization
Organization Name:READING FAMILY PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:513-563-6934
Mailing Address - Street 1:9400 READING RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:OH
Mailing Address - Zip Code:45215-3401
Mailing Address - Country:US
Mailing Address - Phone:513-563-6934
Mailing Address - Fax:513-769-2622
Practice Address - Street 1:9400 READING RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:OH
Practice Address - Zip Code:45215-3401
Practice Address - Country:US
Practice Address - Phone:513-563-6934
Practice Address - Fax:513-769-2622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35065428207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2398856Medicaid
OH2398856Medicaid