# PREMISE HEALTH OF OHIO MEDICAL, P.A

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dollywood Family Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942346275
- **Authorized official:** JON LEIZMAN M.D. (PRESIDENT)
- **Authorized official phone:** (216) 479-9063

## Contact information

- **Practice address:** 1022 DOLLYWOOD LN, PIGEON FORGE, TN 37863-4113
- **Practice address phone:** (865) 908-5322
- **Practice address fax:** (865) 908-9394
- **Mailing address:** 5500 MARYLAND WAY, BRENTWOOD, TN 37027-4948
- **Mailing address phone:** (865) 868-1333
- **Mailing address fax:** (865) 868-1307

## Taxonomy

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

## Other

- **Enumeration date:** 01/30/2007
- **Last updated:** 08/16/2022