Organization
FAYETTE COUNTY MEMORIAL HOSPITAL
Active
Other names
Fayette County Memorial Hospital Medical and Surgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD MICHAEL DIENER (CEO)
(740) 333-2705
Entity
Organization
Contact information
Practice address
1510 COLUMBUS AVE, SUITE # 230, WASHINGTON COURT HOUSE, OH 43160-1899
(740) 333-3333
(740) 333-5171
Mailing address
1450 COLUMBUS AVE, SUITE # B 6-7-8, WASHINGTON COURT HOUSE, OH 43160-3701
(740) 333-2236
(740) 333-3881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1168
OH
207R00000X
Internal Medicine Physician
1168
OH
208600000X
Surgery Physician
1168
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2970665
—
OH
Enumeration date
11/09/2006
Last updated
05/14/2020
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