# MONTGOMERY FAMILY PRACTICE, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144390345
- **Authorized official:** DR. GINGER S KUBALA MD (PRESIDENT MD)
- **Authorized official phone:** (513) 791-1201

## Contact information

- **Practice address:** 10550 MONTGOMERY RD STE 11, MONTGOMERY, OH 45242-4495
- **Practice address phone:** (513) 791-1201
- **Practice address fax:** (513) 791-1231
- **Mailing address:** 10550 MONTGOMERY RD, \# 12, CINCINNATI, OH 45242
- **Mailing address phone:** (513) 791-1201
- **Mailing address fax:** (513) 791-1231

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 35057045 | OH | — |
| 207Q00000X | Family Medicine Physician | 35067638 | OH | — |
| 207Q00000X | Family Medicine Physician | 350728718 | OH | Yes |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 01/11/2023