Provider Demographics
NPI:1235828245
Name:BUCKEYE MOBILE DOT EXAMS
Entity Type:Organization
Organization Name:BUCKEYE MOBILE DOT EXAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:MR
Authorized Official - First Name:WEST
Authorized Official - Middle Name:N
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:937-641-9389
Mailing Address - Street 1:PO BOX 532
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45338-0532
Mailing Address - Country:US
Mailing Address - Phone:937-641-9389
Mailing Address - Fax:
Practice Address - Street 1:532 FLOYD ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:OH
Practice Address - Zip Code:45338-9572
Practice Address - Country:US
Practice Address - Phone:937-641-9389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center