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Organization

NORTHRIDGE FAMILY PRACTICE LLC

Active
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Organization

NORTHRIDGE FAMILY PRACTICE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DEBORAH LEA LEWIS (OFFICE MANAGER)
(740) 474-3159
Entity
Organization

Contact information

Practice address
610 NORTHRIDGE RD, CIRCLEVILLE, OH 43113
(740) 474-3159
(740) 474-2110
Mailing address
610 NORTHRIDGE RD, PO BOX 578, CIRCLEVILLE, OH 43113
(740) 474-3159
(740) 474-2110

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35042158B
OH
207Q00000X
Family Medicine Physician
350463858
OH
207Q00000X
Family Medicine Physician
35053974M
OH
207Q00000X
Family Medicine Physician
35071002J
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2211430
—
OH
Enumeration date
11/10/2005
Last updated
12/11/2019
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