Provider Demographics
NPI:1275606378
Name:DELPHOS MEDICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:DELPHOS MEDICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:MONROE
Authorized Official - Last Name:HUX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-692-5611
Mailing Address - Street 1:1800 E 5TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-9139
Mailing Address - Country:US
Mailing Address - Phone:419-692-5611
Mailing Address - Fax:419-695-9401
Practice Address - Street 1:1800 E 5TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DELPHOS
Practice Address - State:OH
Practice Address - Zip Code:45833-9139
Practice Address - Country:US
Practice Address - Phone:419-692-5611
Practice Address - Fax:419-695-9401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0517944Medicaid
OHDE9318821Medicare PIN