# ADVANCED FAMILY MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851891279
- **Authorized official:** JAMES CAMERON JOHNSON (D.O.)
- **Authorized official phone:** (614) 875-0079

## Contact information

- **Practice address:** 4160 BROADWAY, GROVE CITY, OH 43123-3024
- **Practice address phone:** (614) 875-0079
- **Mailing address:** 4160 BROADWAY, GROVE CITY, OH 43123-3024
- **Mailing address phone:** (614) 875-0079

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | NULL | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | — | — |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/13/2018
- **Last updated:** 01/27/2021