Provider Demographics
NPI:1417927849
Name:BOWLING GREEN FAMILY PHYSICIANS. INC.
Entity Type:Organization
Organization Name:BOWLING GREEN FAMILY PHYSICIANS. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:HORRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-352-9071
Mailing Address - Street 1:1215 RIDGEWOOD DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-2690
Mailing Address - Country:US
Mailing Address - Phone:419-352-9071
Mailing Address - Fax:419-352-9073
Practice Address - Street 1:1215 RIDGEWOOD DR
Practice Address - Street 2:SUITE B
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-2690
Practice Address - Country:US
Practice Address - Phone:419-352-9071
Practice Address - Fax:419-352-9073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2574209Medicaid
OH07386013OtherAETNA INSURANCE
OHBO9354481Medicare ID - Type Unspecified