Provider Demographics
NPI:1467119891
Name:MONROE FAMILY MEDICINE
Entity Type:Organization
Organization Name:MONROE FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-461-2273
Mailing Address - Street 1:262 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050-1236
Mailing Address - Country:US
Mailing Address - Phone:513-461-2273
Mailing Address - Fax:513-536-6929
Practice Address - Street 1:262 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:OH
Practice Address - Zip Code:45050-1236
Practice Address - Country:US
Practice Address - Phone:513-461-2273
Practice Address - Fax:513-536-6929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty