Organization
GENESIS MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE D NORMAN (CFO)
(740) 454-4773
Entity
Organization
Contact information
Practice address
945 BETHESDA DR STE 200, ZANESVILLE, OH 43701-1880
(740) 450-6147
Mailing address
945 BETHESDA DR, SUITE 200, ZANESVILLE, OH 43701-0801
(740) 450-6147
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2861809
—
OH
Enumeration date
10/03/2008
Last updated
03/01/2021
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