Provider Demographics
NPI:1790517431
Name:MARKOVITZ MEDICAL LLC
Entity type:Organization
Organization Name:MARKOVITZ MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-508-6290
Mailing Address - Street 1:1430 TROY HILL RD
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-9642
Mailing Address - Country:US
Mailing Address - Phone:937-653-1001
Mailing Address - Fax:183-397-3471
Practice Address - Street 1:300 PATRICK AVE
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-2339
Practice Address - Country:US
Practice Address - Phone:937-653-1001
Practice Address - Fax:833-973-4717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty