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Organization
WESTERN MEDICINE, INC.
Active
Organization
WESTERN MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB THOMAS DEAN M.D. (OWNER)
(937) 864-7363
Entity
Organization
Contact information
Practice address
7774 DAYTON SPRINGFIELD RD, FAIRBORN, OH 45324-1957
(937) 864-7363
(937) 864-5895
Mailing address
PO BOX 339, ENON, OH 45323-0339
(937) 864-7363
(937) 864-5895
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35081458
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2632593
—
OH
Enumeration date
02/07/2006
Last updated
08/07/2019
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