Provider Demographics
NPI:1750319760
Name:FAMILY PHYSICIANS OF COSHOCTON, INC
Entity Type:Organization
Organization Name:FAMILY PHYSICIANS OF COSHOCTON, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-622-0332
Mailing Address - Street 1:440 BROWNS LN
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-2044
Mailing Address - Country:US
Mailing Address - Phone:740-622-0332
Mailing Address - Fax:740-622-0335
Practice Address - Street 1:440 BROWNS LN
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-2044
Practice Address - Country:US
Practice Address - Phone:740-622-0332
Practice Address - Fax:740-622-0335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
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
OHFA9263921Medicare ID - Type UnspecifiedCORP. NUMBER