Provider Demographics
NPI:1336460880
Name:JOHN D MOLESKY DO INC
Entity Type:Organization
Organization Name:JOHN D MOLESKY DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOLESKY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:937-473-3025
Mailing Address - Street 1:550 MOTE DR STE 2
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45318-1273
Mailing Address - Country:US
Mailing Address - Phone:937-473-3025
Mailing Address - Fax:
Practice Address - Street 1:550 MOTE DR STE 2
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:OH
Practice Address - Zip Code:45318-1273
Practice Address - Country:US
Practice Address - Phone:937-473-3025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-002839M207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty