Provider Demographics
NPI:1700048485
Name:VILLAGE MEDICAL OFFICE INC
Entity Type:Organization
Organization Name:VILLAGE MEDICAL OFFICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:FRANZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-888-3377
Mailing Address - Street 1:18 GRACE DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-8466
Mailing Address - Country:US
Mailing Address - Phone:614-888-3377
Mailing Address - Fax:614-885-5855
Practice Address - Street 1:18 GRACE DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-8466
Practice Address - Country:US
Practice Address - Phone:614-888-3377
Practice Address - Fax:614-885-5855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35059038174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0807461Medicaid
OHD71522Medicare PIN