Provider Demographics
NPI:1497800676
Name:FAMILY FOCUSED HEALTH ASSOCIATES PLLC
Entity Type:Organization
Organization Name:FAMILY FOCUSED HEALTH ASSOCIATES PLLC
Other - Org Name:EDGMON FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDGMON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:740-232-2180
Mailing Address - Street 1:51342 NATIONAL RD STE J
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-1700
Mailing Address - Country:US
Mailing Address - Phone:740-232-2180
Mailing Address - Fax:740-232-2182
Practice Address - Street 1:51342 NATIONAL RD STE J
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-1700
Practice Address - Country:US
Practice Address - Phone:740-232-2180
Practice Address - Fax:740-232-2182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0005909Medicaid
000000232856OtherUNISON
DO1200OtherRAILROAD MEDICARE PTAN
20876AOtherHEALTH PLAN
WV3810011480Medicaid
480549OtherCARELINK/HEALTH ASSURANCE
5697522OtherCIGNA
OH0084837Medicaid
7894459OtherAETNA
1841686000OtherUNISYS
1746706OtherHIGHMARK
000000232856OtherUNISON
7894459OtherAETNA