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Organization
WILMINGTON PHYSICIANS GROUP LLC
Active
Organization
WILMINGTON PHYSICIANS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY J TEAGUE (SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
610 W MAIN ST, WILMINGTON, OH 45177-2125
(937) 382-5438
(937) 382-5260
Mailing address
610 W MAIN ST, WILMINGTON, OH 45177-2125
(937) 283-9845
(937) 283-9839
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
2084N0400X
Neurology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050274
—
OH
Enumeration date
12/03/2010
Last updated
01/21/2019
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