# PHYSICIAN MANAGEMENT SERVICES OF SOUTHERN OHIO, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** VAXCARE CORPORATION
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588173942
- **Legal business name:** VAXCARE CORPORATION
- **Authorized official:** BRETT KENEFICK (PRESIDENT)
- **Authorized official phone:** (888) 829-8550

## Contact information

- **Practice address:** 47 STATE ST, STRUTHERS, OH 44471-1984
- **Practice address phone:** (888) 829-8550
- **Mailing address:** 3113 LAWTON RD STE 250, ORLANDO, FL 32803-3517
- **Mailing address phone:** (407) 480-5986

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/28/2017
- **Last updated:** 04/27/2021