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Organization
SOUTHLAND FAMILY MEDICINE ASSOCIATES INC
Active
Organization
SOUTHLAND FAMILY MEDICINE ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR J STEGALL MD (DIRECTOR)
(419) 629-2772
Entity
Organization
Contact information
Practice address
03920 SOUTHLAND RD, NEW BREMEN, OH 45869
(419) 629-2772
(419) 629-3613
Mailing address
03920 SOUTHLAND RD PO BOX 127, NEW BREMEN, OH 45869
(419) 629-2772
(419) 629-3613
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35 02 4908 B
OH
207Q00000X
Family Medicine Physician
Primary
35 03 2392 S
OH
207Q00000X
Family Medicine Physician
35 04 8500 L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0995811
—
OH
Enumeration date
10/17/2006
Last updated
01/27/2010
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