# MOUNT CARMEL - OSU PHYSICIAN ALLIANCE LLC

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

## Provider details

- **NPI number:** 1871913731
- **Authorized official:** MS. LAURA DORNSIFE (DIRECTOR OF CODING & REVENUE CYCLE)
- **Authorized official phone:** (614) 685-1511

## Contact information

- **Practice address:** 55 PARK AVE, LONDON, OH 43140-1170
- **Practice address phone:** (740) 845-7500
- **Practice address fax:** (740) 845-7501
- **Mailing address:** 700 ACKERMAN RD, SUITE 570, COLUMBUS, OH 43202-1559
- **Mailing address phone:** (614) 293-2391
- **Mailing address fax:** (614) 293-4359

## Taxonomy

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

## Other

- **Enumeration date:** 04/18/2014
- **Last updated:** 04/18/2014