Provider Demographics
NPI:1265560643
Name:GRACE, HELEN FRANCINE (DO)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:FRANCINE
Last Name:GRACE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:FRANCINE
Other - Last Name:GOMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:5141 MORNING SUN RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-9629
Mailing Address - Country:US
Mailing Address - Phone:513-523-2156
Mailing Address - Fax:513-523-2503
Practice Address - Street 1:5141 MORNING SUN RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-9629
Practice Address - Country:US
Practice Address - Phone:513-523-2156
Practice Address - Fax:513-523-2503
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036117367208000000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200960660Medicaid
OH2994274Medicaid